March 2025

CHOICES Corner

Medicare Summary Notices now contain information about a new “right to appeal” related to “observation status” determinations when they are in the hospital. This new right is the result of a class action suit brought by the Centers for Medicare Advocacy on behalf of individuals who were harmed by a change in their hospitalization status from “in-patient” to “observation” status. This lawsuit creates the opportunity for some Medicare recipients to challenge their admission status. The Centers for Medicare Advocacy shared the following information for Medicare recipients:

• “In March 2020, a federal court issued a decision in a nationwide class action, Alexander v. Azar, finding that certain Medicare beneficiaries who are admitted as hospital inpatients, but then reclassified as outpatients receiving observation services (also known as “observation status”), have the right to appeal to Medicare for coverage as hospital inpatients. A federal appeals court affirmed the decision in January 2022.

• Medicare released the final regulations implementing the court’s decision in October 2024.”

The significance of admission status is especially important and can greatly impact care decisions and costs to the Medicare recipient. As the Center reports:

Click to read the full article .

This newsletter is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $577,233 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.    

CAREGIVER Corner:

Adult Day Centers are effective resources that can help you care for your loved one at home and still make certain there is time for you to focus your time and attention on activities besides caregiving. Many caregivers resist using this resource. There are many reasons: your loved one is not interested; there is a cost involved; it is too hard to get him/her there; (s)he might need me, and I will not be available. All true, but all can be addressed. 

• Very few people aspire to attend an adult day center (ADC), however, once given the opportunity to participate, almost all like it.
• There is a cost, but there is a cost for pretty much everything in life. Some things are worth the cost. Also, many of the ADCs have scholarships for part of the costs if there is a genuine need. Your relative doesn’t have to attend every day to get a benefit from participation. Some people only attend once per week. Depending on the model center you select, they may be able to provide shower and shampoo service. For many caregivers, the bath is one of the most difficult challenges. The ADC can provide that with trained staff, in fully accessible bath facilities. That alone is worth the price of participation.



Click to read the full article .