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Brown: Close Medicare loophole that costs seniors thousands

Howard Wilkinson
Sen. Sherrod Brown at Maple Knoll Retirement Village

Sen. Sherrod Brown came to a retirement home in Springboro this morning to tout a bill he says would close a Medicare loophole that is costing many seniors thousands of dollars in unexpected medical bills.

The Ohio Democrat told a roomful of about 50 seniors at Maple Knoll Retirement Village that his “Improving Access to Medicare Act” has bipartisan support in both the House and Senate and, if passed, will prevent “a lot of seniors from getting socked by a much larger bill than they expected.”

Brown’s bill would allow for the time patients spend in the hospital under “observation status” to count toward the three-day hospital day requirement for Medicare coverage of skilled nursing care once they are discharged from the hospital.

Now the patients must be admitted to the hospital for at least three days before Medicare will pick up the costs of their skilled nursing care. Being on “observation status” doesn’t count.

“The hospitals don’t want to be audited and find out that they admitted someone who should have been under observational status,’’ Brown said.

Brown said he does not yet know what the cost of his bill would be to the Medicare system, but said he should have a figure “in a couple of weeks.”

Kenneth Huff, the executive vice president and chief financial officer of Maple Knoll said at least one of these cases comes across his desk every week.

What the current law means, Huff said, “is that you are responsible for the first 20 days of skilled nursing care, and that costs about $7,000.

Carol Wolf, a Cincinnati woman, told the story of her 97-year-old father who fell last spring and suffered a broken back and a head injury. After he left the hospital for rehabilitation care, Wolf said the family was told that he had been in University Hospital under “observation status” and that Medicare would not pay. It ended up costing the family about $5,000.

“I knew nothing about observation status,’’ Wolf said. “We need to get the word out on this. People need to know what is happening.”

Brown said his bill “would help ensure that seniors receive the care they need without incurring unexpected and unfair costs.”

Howard Wilkinson is in his 50th year of covering politics on the local, state and national levels.