PATIENT RIGHTS: WHEN YOU'RE IN THE HOSPITAL, ASK IF YOU'VE BEEN ADMITTED (IMPROVING ACCESS TO MEDICARE COVERAGE ACT OF 2011)

WHEREAS, recent information has shown that there has been a noticeable increase in hospital "observation status" inpatient placement compared to inpatient "admission status"; and in some cases, observation status placement is occurring without the patient's understanding or knowledge of the consequences of such placement to the patient's future financial and physical well-being; and

WHEREAS, admission status patients receive Medicare Part A coverage beginning with a deductible, no copayment for days 1–60 each benefit period, drugs, nursing services, meals, other hospital services and supplies, etc.; and

WHEREAS, admission status Medicare Part A patients confined for a "3-day minimum medically-necessary inpatient hospital stay" qualify for transfer to a skilled nursing facility and rehabilitative services, and such other covered services under Medicare Part A; and

WHEREAS, observation status Medicare Part B coverage provides payment for outpatient hospital services at a 20 percent copayment, and an observation status patient without supplemental health insurance coverage must pay out of pocket for post-hospital care needs, including confinement in a skilled nursing home or rehabilitative services and supplies; and

WHEREAS, the American Federation of Teachers Program on Retirement and Retirees and the Alliance for Retired Americans, as part of the Leadership Council of Aging Organizations, have been engaged since 2010 in efforts to remedy this situation; and

WHEREAS, there currently exists legislative bills, H.R. 1543 (Courtney/Latham) and S. 818 (Kerry/Snowe), titled "Improving Access to Medicare Coverage Act of 2011," that were sent to committees on April 14, 2011, to amend title XVIII of the Social Security Act to count a period of inpatient observation status in a hospital exceeding 24 hours toward satisfying the 3-day inpatient hospital requirement:

RESOLVED, that the American Federation of Teachers and its alliances will conduct a national campaign to urge their memberships, in-service and retired, to contact and seek support from their congressional representatives to move H.R. 1543 and S. 818 or similar legislation from their respective committees and pass legislation forthwith that will correct this flaw in the Affordable Care Act of 2011; and

RESOLVED, that the AFT will encourage its locals and affiliates to examine their health insurance offerings, including Catastrophic Coverage, to seek a waiver to the 3-day inpatient hospital requirement from their insurance providers until such time as the above concern is satisfactorily addressed.