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Medicare Patients 'Under Observation' Face Higher Costs
Simply put: When you're under observation, you're often less insured.
Doctors at Gulf Coast Medical Center were about to discharge 95-year-old June Stanley to a rehabilitation center last spring when Stanley's daughter remembered something she had read about how hospitals classify patients.
Was her mother admitted during her stay?, Carole Brokke wondered. Or had medical staff considered her only "under observation," despite her three days in a hospital bed?
The answer would mean the difference between a standard Medicare bill or one with potentially tens of thousands of dollars in out-of-pocket costs. It turns out that Stanley, who had recently taken a hard fall at a Lehigh Acres nursing home, had not been officially admitted. Insurance would not pay for skilled nursing care.
Read the full story here: http://newspr.es/1hB8KGX
Source: News Press
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Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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The Biden administration recently launched the Global Health Security Strategy, a new effort to combat the spread of infectious diseases; lawmakers zeroed in on the risks of massive consolidation in health care during the first congressional hearing on the Change Healthcare hack; the FDA recently announced the recall of a pair of heart devices linked to numerous deaths and injuries.
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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