New Observation Status Rules What they will mean

New Observation Status Rules What they will mean for your clients

Observation Status • A patient on observation status is considered an outpatient and Medicare Part B cost-sharing rules apply to the medical tests, treatments and drugs • Time on observation status won’t be counted toward Medicare’s three-night’s stay requirement to cover care at a skilled nursing facility after discharge.

NOTICE Act • Applies to patients who have been hospitalized and classified as an outpatient for 24 hours. After being an outpatient for 24 hours, the hospital has 12 hours to give them notice. – Verbally and in writing

Timeline Consider this hour one 24 hours as an outpatient on observation status Given observation status designation by doctor. 36 hours Hospitals must have given written and verbal notice within this time frame

The Written Notice • Written notice must explain cost-sharing rules for outpatient services • And explain that being on observation status does not count toward three-day inpatient minimum for Medicare to cover costs of care at a skilled nursing facility

Be an Advocate You: – educate your clients about the new law Patients/their family: – ask about their status when in the hospital

For More Information • Observation Status tip sheet • Center for Medicare Advocacy

Licensed Clinical Social Worker Medicaid Billing Senate Bill 2332 and House Bill 4526

Background • In 2007, Illinois General Assembly passed a law that gave Licensed Clinical Social Workers the ability to bill Medicaid. • But never created rules to implement the law

Senate Bill 2332 & House Bill 4526 • Proposed legislation would require the Department of Healthcare and Family Services to make rules to implement law

Be an Advocate • The National Association of Social Workers (NASW) Illinois chapter is leading advocacy for this bill. • http: //www. naswil. org/advocacyalerts/

New Department of Labor Overtime Rule How it could impact clients receiving home services

Background • New Department of Labor regulations extend overtime protections to home care workers. • State is saying that it can’t pay for the overtime pay – capping the number of hours at 35, with 5 hours of additional travel time

Status • Ongoing negotiations between the State and SEIU representing the PAs

Be an Advocate • Looking for stories of consumers who could be impacted • Advise clients to get DON score and keep on file