Print this page

One of the major benefits of Medicare is its hospitalization coverage. Starting July 1, 2007 new notice requirements went into effect for Medicare patients being discharged from the hospital. As anyone knows who has had a loved one hospitalized in the last decade, the amount of time a patient remains in the hospital is getting shorter and shorter.

This new regulation requires hospitals to provide to all Medicare patients information about their discharge in advance and the patient's rights to appeal. Therefore it is important to be aware of this new requirement if you feel the discharge is premature.

Within two days of admission to a hospital, individuals with Medicare insurance must receive a notice called "An Important Message from Medicare about Your Rights" (IM) explaining your discharge and appeal rights. You will be asked to read the notice sign and date it. The hospital is also required to give you a second IM prior to your discharge.

However, if you are told of a pending discharge and you are not ready to leave, you should immediately contact your local Medicare Quality Improvement Organization, at the phone number identified on the notice, for an external review: This review is completed by a group of doctors and other professionals who monitor the quality of care delivered to Medicare recipients. They are paid by the federal government and not affiliated with the hospital.

The phone call to the local Quality Improvement Organization must be made by noon on the first business day after you receive your discharge notice. If you do this you will not have to pay for your care while you wait for your discharge to be reviewed, nor can the hospital discharge you while you await this decision.

Of interest, as a Long Term Care consultant, this process of notice of Medicare appeal rights and education has been required for many years in nursing homes. Many older adults and their families who have had experience in nursing homes or sub-acute settings may know and remember this process.