Judith Waltz Discusses Second Circuit Decision on the Constitutional Rights of Medicare Beneficiaries

31 January 2022 Report on Medicare Compliance News News

Foley & Lardner LLP Partner Judith Waltz was quoted in the article, "Court: Patients Must Be Able to Appeal Status Change from Inpatient to Observation," in the Report on Medicare Compliance, published by the Health Care Compliance Association (HCCA).

The U.S. Court of Appeals for the Second Circuit recently said that the constitutional rights of Medicare beneficiaries are violated when they can’t appeal a hospital’s decision to change their status from an inpatient to an outpatient receiving observation services. The court ordered the Centers for Medicare & Medicaid Services (CMS) to allow an appeals process for denials of inpatient status under certain circumstances.

“It’s uncertain how CMS will apply it,” said Waltz, and "the real-world mechanics are worrisome. It’s going to be hard to design a fair and effective appeal process.”

Waltz is the co-chair of the firm’s Health Care Practice Group and Health Care Industry Team.