Re “A sick system” (Op-ed, July 21): The story of the classification of Robert Kuttner’s mother as an “outpatient” when she was in the hospital for four days is all too familiar to Medicare advocates. The use of so-called observation status has increased exponentially for patients who are in the hospital and receiving treatment that is indistinguishable from that given to inpatients.

The effect on beneficiaries is disastrous. Many lose coverage for medically necessary post-hospital care because Medicare requires a prior inpatient hospital stay to qualify for nursing home coverage.

The Center for Medicare Advocacy represents beneficiaries in a nationwide class-action lawsuit challenging Medicare’s use of observation status and beneficiaries’ inability to appeal their outpatient classifications. The fiction of outpatient observation status deprives hospitalized Medicare beneficiaries of the coverage that they are granted by law and necessary post-hospital care. It should be eliminated.

Judith Stein
Executive director
Center for
Medicare Advocacy
Willimantic, Conn.