AHA Feb. 26 submitted comments on the Centers for Medicare & Medicaid Services’ proposed rule establishing appeals rights for Medicare beneficiaries admitted for an inpatient hospital stay subsequently reclassified to an outpatient stay with observation services. The rule, which establishes both retrospective and prospective appeal rights for beneficiaries, is a result of a court decision in the case of Alexander v. Azar. In comments, AHA said it supports the agency’s general approach and offered recommendations to ensure beneficiaries better understand CMS policies and to help clarify and reduce the burden of these appeals on all parties involved. AHA also asked CMS to temporarily use its enforcement discretion regarding the proposal that hospitals timely deliver a new notice called a Medicare Change of Status Notice, in order to determine whether changes or additional requirements are warranted.

Related News Articles

Perspective
Public
More than 34.1 million Americans were enrolled in a Medicare Advantage plan in 2025, accounting for 54% of all Medicare beneficiaries. We have seen enrollment…
Headline
A KFF analysis released Jan. 28 found that Medicare Advantage insurers made nearly 53 million prior authorization determinations in 2024, an increase…
Headline
The Centers for Medicare & Medicaid Services Jan. 26 released proposed changes to Medicare Advantage plan capitation rates and Part D payment policies for…
Headline
The AHA Jan. 26 expressed support and provided its perspective on certain provisions within the Centers for Medicare & Medicaid Services’ proposed…
Headline
The AHA Jan. 20 made recommendations to Congress on modernizing the Medicare Access and CHIP Reauthorization Act. Among the proposals, the AHA recommended…
Headline
The comment period for the Centers for Medicare & Medicaid Services' proposed rule for policies governing the Medicare Advantage and Part D programs for…