H.R. 5232 — Introduced in House

I 113th CONGRESS 2d Session H. R. 5232 IN THE HOUSE OF REPRESENTATIVES July 29, 2014 Mr. Doggett (for himself and Mr. Young of Indiana) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII of the Social Security Act to require hospitals to provide certain notifications to individuals classified by such hospitals under observation status rather than admitted as inpatients of such hospitals. 1. Short title This Act may be cited as the Notice of Observation Treatment and Implication for Care Eligibility Act or the NOTICE Act. 2. Medicare requirement for hospital notifications of observation status (a) In general Section 1866(a)(1) of the Social Security Act (42 U.S.C. 1395cc(a)(1)) is amended— (1) in subparagraph (V), by striking at the end and; (2) in the first subparagraph (W), by striking at the end the period and inserting a comma; (3) in the second subparagraph (W)— (A) by redesignating such subparagraph as subparagraph (X); and (B) by striking at the end the period and inserting , and; and (4) by inserting after such subparagraph (X) the following new subparagraph: (Y) in the case of a hospital, to provide to each individual who is entitled to benefits under part A and who the hospital classifies for more than 24 hours as an outpatient under observation status or any other similar status, as the Secretary determines appropriate (or to a person acting on the individual’s behalf), not later than 36 hours after the time of such classification of such individual under such status (or, if sooner, upon discharge), an adequate oral and written notification (as defined by the Secretary pursuant to rulemaking and containing such language as the Secretary prescribes consistent with this paragraph) which— (i) explains the status of the individual as an outpatient under such observation status or any other such similar status and not as an inpatient of the hospital; (ii) explains the reason for the classification of such individual under such status; (iii) explains the implications of such status as an outpatient on— (I) eligibility for coverage of items and services under this title, including such items and services furnished by the hospital with respect to such individual while under such status and for items and services under this title for a subsequent discharge to a skilled nursing facility or other facility; and (II) cost-sharing requirements under this title, including with respect to items and services furnished by the hospital to such individual while under such status and with respect to items and services under this title for a subsequent discharge to a skilled nursing facility or other facility; (iv) includes the name and title of the staff of the hospital who provided the oral notification and the date and time of such oral notification; (v) includes such additional information as the Secretary deems appropriate; and (vi) in the case of the written notification, is— (I) signed by such individual (or person acting on the individual’s behalf) to acknowledge receipt of such notification; (II) written and formatted using language that is clear and easily understandable to Medicare beneficiaries; and (III) made available in different languages, as specified by the Secretary. . (b) Effective date The amendments made by subsection (a) shall apply with respect to items and services furnished on or after the date that is six months after the date of the enactment of this Act.