Back to the Basics – The Notice Act

Rising Medical Bills

Experiencing a life threatening accident or injury is one of the scariest and most confusing times in a person’s life, but what further complicates these emotional times are the staggering medical bills received after, without warning. In an effort to combat receiving these unexpectedly high bills and further open communication between hospital and patient, The NOTICE, or Notice of Observation of Treatment and Implication for Care Eligibility, Act will change the way patients are notified about potential costs incurred.

Starting in August 2016, this Act requires that hospitals throughout the country notify a patient about their status as either ‘inpatient’ or ‘observation’ status. When classified as an inpatient, Medicare will cover all, or a substantial amount, of  the costs of medical bills incurred by the patient if they are covered under it. However, if the patient is classified as being under observation, Medicare may no longer be responsible for the bills incurred and the out of pocket costs fall on the patient, which has commonly been unbeknownst to the patient until release or weeks later when the bill is received. In order for an elder to receive care at a nursing home following a hospital visit, they must have spent three days in a hospital under inpatient status.

Changing Times

The NOTICE Act now requires that the hospital notify a Medicare beneficiary patient who is under observation status of their status if they have been at the hospital for over 24 hours. This notice given to the Medicare beneficiaries must be in writing and will state that (1) the status of the individual is not as an inpatient, (2) reasoning for the person’s status as ‘observation’, and (3) the potential consequences and implications of lack of eligibility under Medicare and thus increased monetary responsibility. Acknowledgement of understanding is given by the patient signing the notice and returning it to the hospital.

While some critics are worried about the potential impact it may have on a patient concerned about medical bills deciding to refuse medical assistance or advice, supporters of the Act note that many elders will be greatly impacted by the disclosure and are encouraged by the potential it has to increase communication between both parties. Here in New York, as well as Connecticut, Maryland, Pennsylvania and Virginia all have already implemented similar disclosure methods in order to better protect the aging population throughout their battles with health issues.

Contact Information