'I'MK tiAZKTTK-TIMES. Hfppnr. OR. Ttturotay. Sp. t. I97. Pg S
Medicare
questioned
ran
f1 'j
Lftl
ill l Liu
V
, If you're on Medicare, don't go into the hospital until you
read this. The chances are good that your hospital benefits
may be cut off before you are ready to be discharged by your
doctor.
New Medicare rules require that at some point during your
hospital stay, you may have to decide whether to pay any
additional bills yourself or go home before you're ready.
It's nothing new that Medicare doesn't cover everything
and there has always been grumbling because it doesn't
cover as much as many people think it should. But the most
grumbling comes after people find out that Medicare doesn't
cover something when they were sure it did.
This often Involves an after-the-fact decision by Medicare
that a portion of a hospital stay wasn't covered because the
patient didn't really require the kind of care that is available
only in a hospital. Medicare doesn't say that the patient had
adequate recovered. It merely says that further
hospitalization hadn't been necessary. It often happened that
a patient's condition was stabilized to the point where
; Medicare contended hospitalization was no longer necessary.
, An example is when the doctor feels that to be on the safe
tide, an elderly patient who still isn't strong enough to be up
and around without help should' stay in the hospital longer
. because there isn't anybody at home able to provide the kind
of help the patient needs. Although this is a serious health
problem, it's not the kind Medicare will pay for. This is one of
the hard facts about the law and one of the most troublesome
in the entire Medicare program.
In the past, this often resulted in financial hardship
because whenever Medicare denied part of a claim, the
responsibility for payment of the disallowed portion of the
bill unexpectedly fell on the patient. Many times big bills
came up long after the patient left the hospital thinking
Medicare had covered the entire stay.
' To remedy some of the financial hardship these
misunderstandings caused, Congress changed the law to
provide that in cases where neither the patient nor the
hospital had any reason to know that the services were not
covered, Medicare would pay the bill on a "this-time-only"
basis. This is known as the "waiver of liability."
If the same coverage question comes up again, Medicare
can say to the hospital, "You should have known it wasn't
covered," and refuse to pay the bill. Patients having no
reason to know that the services aren't covered are not liable
for the bill even If Medicare doesn't pay. If it's the hospital's
mistake, the hospital gets stuck for it.
Well, during the last few years, hospitals have been "put on
notice" by Medicare in more and more such cases. This
means that by now, in Just about every case where a
Medicare patient isn't discharged from the hospital as soon
as Medicare later decides was the time to do so, the hospital
must foot the rest of the bill itself unless the patient has been
promptly notified that the hospital stay was no longer
covered by Medicare. A patient remaining in the hospital
after getting such a notice is responsible for the portion of the
bill not allowed by Medicare.
The new rules make it look to the patient as if it's the
hospital itself terminating the benefits. I say this because
hospitals were required to prepare and file with Medicare a
"written procedure for terminating benefits." Hospitals
were told, "Failure to submit the written description of your
procedures for terminating benefits will result In loss of
protection of the waiver of liability."
Even the wording of the hospital's written notice to the
patient is specified In the rules. So you may get a letter from
the hospital before your doctor wants you to go home: "...
Your condition has improved to a point where you no longer
require inpatient hospitalization. As a result, the care you
are now receiving is no longer payable under Medicare.
Should you wish to remain in the hospital after receipt of this
letter, you will be financially responsible for any charges
Incurred."
If you get such a letter, don't blame the hospital. It may
have had a gun In its back when it sent it.
Kinzua teams
win $, prices
Five Kinzua Corporation
safety teams completed seven
months without an accident
this month to earn cash
dollars and drawing prizes
through the company's Incentive-safety
program.
Five teams qualified for the
cash prizes of 130 to each team
member. Kinzua gave away In
excess of $1800 in cash.
Also, each team qualified
for a drawing. One person
from each team had his name
drawn for 19 inch table color
television or a console-Hero
AM FM with an 8 track play
er. The teams and their draw
ing winners were: "B" team
log yard swing shift, TV won
by Rick Johnson; "O" team
construction mill rights, ma
chinists and guards, TV won
by Gary Power; "N" team
lywood millrighta, janitors
and sprinkler men, TV won by
Dan Morris; "Q" team, saw
mill day shift, TV won by
Dclmar Buschke; and "R"
team, sawmill swing shift,
stereo won by Ray Papineau.
BMCC urges
quick registration
It you ar planning on
enrolling In Blue Mountain
Community College this fall
and haven't sent your Appll
t cation for Enrollment lo the
college, do it as soon as
pots ible. This Is the advice of
I President Ron Daniels If you
want to uv llt time
f during the regular regiilra
I Uofl period Sept. &
t The college has Installed a
new computer, Daniels said,
land Ihoae stuilents whone
applications art on file and
i who have been through a pr
, reglitratlon Interview at the
college should shave an hour
or more from the normal re
gistration time.
Prospective students are
urged to visit the college
Counseling Center by Sept. 10
if they have not already had a
prt-registratlon interview.
Academic programs can be
selected and advisers assign
ed during the summer, Dan
iels explslned, and where
necmsary, placement I cits
csn be arranged. The counsel
ing office Is open week days
from I a m. to S p m. and
Tuettiy evening from to I
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tsatn
L
room
Tissue
39
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