Medicare: Judge Dismisses Observation Care Lawsuit; Medicare Penalizes Every D.C. Hospital, 5 In Va. Suburbs

A federal court judge dismissed a lawsuit Monday which was filed against the government by 14 Medicare beneficiaries who were denied nursing home coverage because they had been kept in the hospital under "observation status." Meanwhile, an analysis shows that Medicare penalized every hospital in D.C. and five in the Virginia suburbs for readmission rates, and the California Health Report looks at efforts to reduce the costs of dual eligible patients. 

Kaiser Health News: Capsules: Federal Judge Throws Out Lawsuit Over Hospital Observation Care
A federal court judge in Hartford, Conn., dismissed a lawsuit Monday which was filed against the government by 14 Medicare beneficiaries who were denied nursing home coverage (Jaffe, 9/23).

Kaiser Health News/The Washington Post: Medicare Penalizes Hospitals In Effort To Reduce The Number Of Patients Readmitted
Every hospital in the District and five in the Virginia suburbs will be penalized in the second round of Medicare's campaign to reduce the number of patients readmitted to hospitals within a month, according to federal records. Nationwide, Medicare identified 2,225 hospitals that will have their reimbursements for patient care reduced starting Oct. 1 because readmissions at each occurred more frequently than Medicare believes they should have. Hospitals that treated large proportions of low-income patients were more likely to be penalized than those treating the fewest low-income patients (Rau, 9/23).

California Health Report: Planning For The Most Expensive Patients
Some of the costliest care in the nation goes to the nine million people who are enrolled in both Medicaid and Medicare. Dubbed dual-eligibles, these low-income seniors and younger people with disabilities qualify for the insurance program for seniors (Medicare) and the insurance program for the poor (Medicaid, called Medi-Cal in California). Dual-eligibles often have complicated illnesses. But that’s not the only reason why their care is so expensive, with yearly spending for their care exceeding $300 billion (Shanafelt, 9/24).

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