The Centers for Medicare/Medicaid Services (CMS) will be implementing the Medicare Outpatient Observation Notice (MOON) program nationwide. This will impact Medicare patients placed in "observation status" in a hospital for more than 24-hours. During this time, a patient will receive the best care possible, including any necessary diagnostic tests or lab work, and will be designated as an "Outpatient" for insurance purposes while their health status is monitored. After 24 hours of observation, a doctor is required by law to inform the Medicare patient of their "observation" status.
When the doctor determines that a patient requires a longer period of care, the patient is admitted and placed in "inpatient status". Collaboratively with a team of healthcare professionals, the doctor determines whether the condition requires the patient to be changed to inpatient status or if the remainder of the recovery can occur safely at home.
The MOON policy requires this notification to ensure the patient is informed and made aware of their status while in the hospital. "Observation" and "Inpatient" status are billed and reimbursed differently and at different rates through Medicare.
"At Gila Regional, our primary focus is to get the patient better by providing the best care possible," said Janice Zolotar, Discharge Planning Director at Gila Regional Medical Center (GRMC). "We have to do so within the regulations and requirements set by the CMS and the federal government."
CMS passed this change of policy in April of 2016, and it will impact hospitals nationwide beginning August 1, 2016. For more information please call Janice Zolotar, GRMC's Discharge Planning Director at (575) 538-4019 or contact KEPRO Quality Improvement Organizations at 1-844-430-9504.