New law for hospital patients

A new state law affecting hospital patients took effect Wednesday, Oct. 1. It requires hospitals to advise patients of their status — under observation or inpatient — with 24 hours of placement.

During the past few years, it has not been uncommon for patients to be admitted for treatment at hospitals on an observation status, rather than inpatient status. In some cases, they have not been informed of their status by hospitals. Patients on observation status may face costs that substantially exceed those they would otherwise incur.

This notice now required by law must include:

  • A statement that the patient is not admitted to the hospital but is under observation status.
  • A statement that observation status may affect the patient’s Medicare, Medicaid or private insurance coverage for hospital services, including medications and pharmaceutical supplies; home or community-based care; and care at a skilled nursing facility upon the patient’s discharge.
  • A recommendation that the patient contact his or her health insurance provider or the Office of the Healthcare Advocate to understand better the implications of placement in observation status.

“Everyone, including Medicare and Medicaid participants, needs to know about this change in the law,” said Wilton state Rep. Gail Lavielle. “Understanding how health insurance works is not always easy. It’s important for patients to know their rights regarding transparent information. In the case of hospital stays, when patients are made aware of their status in a timely manner, they have time to plan for their insurance costs and needs, and they also have an opportunity to inquire about the possibility of changing their status.”

If they are not so informed, patients remaining in a hospital more than 24 hours for treatment should take the initiative to ask doctors about their status. Patients placed on observation status should immediately contact their insurance companies.

Patients may request a change in their status. The Center for Medicare Advocacy can provide free assistance at medicareadvocacy.org.

Assistance is also available from Connecticut’s Health Care advocate, Victoria Veltri, at 860-331-2441 or Victoria.Veltri@CT.Gov

Ms. Lavielle’s office can also provide additional information or assistance at 860-240-8700 or gail.lavielle@cga.ct.gov.