A shout-out today for Diane Paulson, senior attorney for the Medicare Advocacy Project at Greater Boston Legal Services. She has been leading the local effort to change Medicare’s use of hospital “observation status,” which has left some seniors with large bills to pay for rehabilitation therapy. The entire Massachusetts delegation is now supporting legislation “Improving Access to Medicare Coverage Act of 2013,” Paulson reports.
The problem is becoming more well known, but Paulson was on the case from the start, more than a year ago, when complaints began coming in from elders and their families who were stuck with medical bills in the thousands for rehabilitation therapy after hospital stays.
Medicare wouldn’t pay because they had never been officially “admitted” to hospitals, but instead were quietly placed on “observation status” — and then given standard treatments, sometimes for days, before discharge.
Pending legisation would change this unfair method shifting medical costs to families. Paulson has been pushing hard for it. Tuesday she reported the entire Massachusetts Congressional delegation is now supporting the legislation, “Improving Access to Medicare Coverage Act of 2013,” House Bill No. H.R. 1179 and Senate Bill No. S. 569.
In an email sent this week to advocates in Massachusetts, she said, “As you may be aware, hospitals are increasingly hospitalizing unknowing Medicare beneficiaries in outpatient “observation” status, rather than as inpatients. This, among other problems, deprives the beneficiaries of the ability to access the Medicare-covered post-hospitalization rehabilitation or skilled nursing facility services to which they might otherwise be entitled.
“Bipartisan support (is building) for this legislation which would allow observation days to count towards the Medicare skilled nursing facility coverage. Now is the time to call your Senators and Representative, thank them for their support, and tell your story. Every call makes a difference!”
Paulson is also representing Ann Gillis, 82, a Milton elder in her appeal to Medicare of a bill Gillis had to pay for skiled nursing rehab therapy after a hospital stay at Beth Israel Deaconess Medical Center in Milton.
Paulson has a long and accomplished track record. She was honored with the Advocate of the Year award by the statewide Massachusetts Councils on Aging and Senior Center Directors in 2011. This award goes to the individual who “by way of message, achievement, legislation, coalition building, speaking up for seniors, helping seniors to speak up, courage, patience, and persistence has helped seniors find empowerment, enrichment and fulfillment.”
She continues to lead by example, to make a significant difference in the lives of elders, and to give families a voice.
On Sept. 19, Paulson contacted advocates with a request to put the pressure on the Congressmen who were not supporting the change. “All but three Massachusetts Representatives (Michael Capuano, Stephen Lynch and Richard Neal) have signed on as sponsors,” she said then.
“Because one or two of the Representatives who has not signed on is in your service area, I am writing to urge that you, if you can, or clients or family members who have been or may be adversely impacted by the current policy, call or write the appropriate Congressman to enlist his support. It would be great if we could get the entire Massachusetts delegation on board!”
Mission accomplished, so far, and the fight will continue.