When you or a loved is discharged from a hospital or nursing facility, it can be a very stressful process, and can be even more difficult if the patient, and their family or caregiver, are unaware of their options. Medicare beneficiaries have important rights to receive proper medical care.
When a Medicare patient enters a hospital or nursing facility, there are strong financial incentives to discharge the patient as quickly as possible. Medicare usually pays hospitals flat rates, based on the type of medical problem being treated. If the hospital spends less money on medical care than Medicare pays, it makes money, but if the hospital spends more than Medicare pays, it loses money. Therefore, the doctors and care providers in these facilities are urged to quickly discharge Medicare patients.
To protect patients from being discharged too quickly, Medicare gives the patient the right to appeal hospital discharge decisions. When a hospital, doctor, or Medicare health plan informs you of your planned date of discharge, it is important to tell them immediately if you think you are not ready to leave. If your concerns about early discharge are not resolved through the staff, you should request an appeal. Medicare will continue to cover your stay, as long as you file the appeal before you are discharged.
When filing an appeal:
HSAG will usually inform you and the hospital of its decision within one day of receiving the necessary information, and is required to do it by telephone and in writing. If HSAG decides that you are not ready to be discharged, Medicare will continue to cover your hospital stay. However, if HSAG finds that you are ready to be discharged, Medicare will continue to cover your services until noon, of the day after HSAG notifies you of its decision.