House Passes Legislation to Protect Seniors from ‘Surprise’ Medical Bills, Says Saylor
4/9/2014
HARRISBURG – Today, the House approved legislation authored by Rep. Stan Saylor (R-York) requiring hospitals to notify patients of their outpatient status, as well as the billing and insurance implications of that designation in order to bring transparency to patients and their families.

The legislation, House Bill 1907, specifies that patients will receive both verbal and written notice that they have not been formally admitted to the hospital if they have been at the hospital for more than 23 consecutive hours.

“The problem I am trying to fix is that many senior citizens don’t even realize they weren’t admitted to the hospital until it’s time for rehabilitation and they are told their insurance doesn’t cover their nursing home bills,” Saylor said.

While hospitals say patients receive the same treatment regardless of their status, the distinction between an outpatient “observation” status and an inpatient admission carries major insurance coverage implications, particularly for Medicare recipients.

For example, Medicare rules require coverage for skilled nursing or nursing home care for up to 100 days after a patient leaves the hospital, but only if the patient meets a three-day qualifying stay as a hospital “inpatient” stay.

So, if a patient is in the hospital for four days, but two of those are designated as “observation,” the patient could face thousands of dollars in added costs and, in some cases, be denied a bed if unable to make an upfront deposit.

The bill now moves to the Senate for consideration.

House Majority Whip Stan Saylor
94th District
Pennsylvania House of Representatives

Media Contact: Charles Lardner
717.260.6443
clardner@pahousegop.com  
www.RepSaylor.com / Facebook.com/RepSaylor
Twitter.com/PAGOPWhip
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