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.
