Two of the greatest sources of frustration for Medicare recipients and their families are hospital observation status and the government’s incredibly complex appeals process. On Monday, a federal judge in Hartford, CT certified a class action lawsuit aimed at addressing both. The judge’s eventual decision in the case (Alexander v. Price) could have far-reaching effects on both the burgeoning use of observation status in hospitals and the rights of people getting Medicare to dispute decisions about their care.
Observation status is intermediate hospital-based care between the emergency department and admission. For example, it may be used for someone who comes to the ED with chest pain but is not suffering heart attack. Doctors may want to keep an eye on the patient for a day or two but determine that she does not require a formal admission. Care is usually provided in a special observation unit, sometimes called a clinical decision unit or CDU.