…Today, lawyers representing 14 seniors, including 7 from Connecticut, will go to U.S. District Court in Hartford to ask a judge to eliminate the observation care designation because it deprives Medicare beneficiaries of the full hospital coverage they’re entitled to under Medicare, including coverage for follow-up nursing home care. More seniors are falling into the observation care coverage gap: the number of observation patients has skyrocketed 69 percent in the past five years, to 1.6 million nationally in 2011, according federal records.Government lawyers will ask the judge to throw out the case because the seniors should have followed Medicare’s appeals process before going to court if they believed they were unfairly denied benefits. And yet federal records and interviews with patients and advocates show that many observation patients who call Medicare about the billing problem hear something quite different – there is nothing that Medicare can do to help. MORE
The nation’s insurance commissioners have some stern advice about proposals to shrink Medicare spending by asking seniors with supplemental Medigap policies to pay more out of pocket for their health care: Don’t do it.
The health law requires the National Association of Insurance Commissioners to advise the administration about whether seniors would use fewer Medicare services — and therefore, cost the government less money — if the most popular Medigap plans were less generous.
“Everything we’ve looked at has shown that increasing cost-sharing does stop people from seeking medical care,” said Bonnie Burns, a training and policy specialist at California Health Advocates who serves on an NAIC committee that has studied the issue for more than a year. “The problem is they stop using both necessary and unnecessary care.” More
Longer version from Kaiser Health News