New class-action lawsuit may add to elder law

Elder care is a serious social and economic issue for Florida, with its high population of seniors requiring medical care. Protections for patients of Medicare, the U.S. federal plan for senior health care, may have seen their costs increase over the last five years, and a new class-action lawsuit seeks to rectify the problem.

The Center for Medicare Advocacy, a Washington D.C.-based organization that supports seniors’ rights to health care under Medicare, was granted class-action status in a lawsuit regarding observation status. The center claims that the designation is purposefully misleading, and creates unmanageable costs for thousands of elderly patients.

A woman was hospitalized under observational status for a week in Florida, and her daughter claims the resultant medical costs forced her to sell her Wellington home. The 88-year-old woman was covered by Medicare part B, like others under observation, so a deductible applies as well as a 20 percent co-payment.

Nursing home visits and admissions are not covered at all, since Medicare policy requires an inpatient stay for three nights before skilled nursing is covered after discharge from the hospital.

Observation status was originally created to give hospitals time for patient evaluation, but its application has skyrocketed for multiple reasons. The lawsuit alleges hospital audits created financial pressure to reduce inpatient admissions.

Florida contains a particularly large number of Medicare beneficiaries, so the use of observation and the results of the class-action suit are likely to highly affect the state’s seniors. A new law, co-sponsored by a Florida senator, would allow patients under observation for three nights to quality for nursing home stays.

Source: Naples News, “Lawsuit aims to give Medicare seniors rights on hospital stay,” Liz Freeman, Aug. 12, 2017