Patients held for observation can face steep drug bills

Susan Jaffe Kaiser
Health News
USA Today

Sudden chest pains landed Diane Zachor in a Duluth, Minn., hospital overnight, but weeks later she had another shock — a $442 bill for the everyday drugs she also takes at home, including more than a half dozen common medicines to control diabetes, heart problems and high cholesterol…

…Even though her health plan covers medical and drug expenses, her policy would not pay the hospital drug bill because St. Luke’s never formally admitted her, instead billing the visit as observation care, which is considered outpatient service.

That observation label excludes thousands of patients every year from full Medicare coverage. Many have spent more than a day in the hospital and had regular hospital rooms and service and, as with Zachor, never realized they weren’t admitted.

These observation patients might wind up paying a larger share of their hospital bills than inpatients, since they usually have a co-payment for doctors’ fees and each hospital service…

…It’s an unwelcome surprise for patients who may not get the bad news until they receive a hospital bill. Medicare has no rules requiring hospitals to tell patients when they are in observation status or that they will be responsible for paying any non-covered Medicare services, said Ellen Griffith, a spokeswoman for the U.S. Centers for Medicare & Medicaid Services…

Read the complete article at USA Today.

Related: In Great Britain, New cancer drugs held up by the NHS for NINE years: Rationing body accused of letting down patients

Patients are being denied potentially life-saving drugs for years because the rationing body NICE is too bogged down in other tasks, doctors and charities have warned. Some patients are waiting for cancer and Alzheimer’s drugs for up to nine years because they take so long to become available.

Update: Why Obamacare is worse than understood by most and must be stopped.

The Supreme Court will rule on the constitutionality of Obamacare this year. The arguments and the issue which got the most publicity was the individual mandate. I don’t actually care much about this although it may well violate the Constitution. There are far worse things in the legislation and they should be emphatically rejected by the Supreme Court. The worst of the issues is discussed in detail here. This is a really frightening piece of legislation and I cannot imagine that the Court will let it stand. Of course, given the absence of argument, the Court will have to find this hidden provision itself…

Read the whole thing.

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