Observation? It could cost you plenty

If you or a loved one has to go to a hospital any time soon and someone says you need to stay for a day or two, it's time to start asking some critical questions.

If you don't, you just might find yourself facing a bill in the thousands you weren't expecting.

As Daily Herald Staff Writer Jamie Sotonoff wrote recently, more and more hospitals in Illinois and nationwide are admitting patients but categorizing them as under “observation.”

That label, in essence, means you're being considered an “outpatient” even though you're in overnight.

And that likely means you'll be responsible for a bill that might not be covered as completely by private insurers or by Medicare.

Linda Brocato, 61, of Prospect Heights broke her leg, needed a straight-leg cast and, therefore, couldn't care for herself at her home. When she got home and got the $13,000 bill, she learned it was not going to be covered by Medicare because the hospital classified her as an “observation” patient rather than an “inpatient.” She is not alone.

Sotonoff reported that U.S. hospitals doubled their “observation” numbers between 2006 and 2008. In Illinois, the numbers of observation patients jumped from 50,000 to 320,000 a year, according to the Illinois Hospital Association.

Hospital representatives say they only are following new Medicare rules. Medicare officials say that isn't so. Some observers suggest hospitals are using the label more often in an attempt to avoid a Medicare audit.

We don't know who's right, but we do know finger pointing isn't going to help anyone facing a huge bill he or she isn't prepared to pay.

Last summer, Sotonoff reported, Democratic Rep. Joe Courtney of Connecticut introduced House Bill 5950 to attempt to solve the problem. The bill would require hospitals to label people as “inpatient” if they are hospitalized for more than 24 hours. Rep. Jan Schakowsky, an Evanston Democrat, supports the legislation.

“People don't really understand, in the midst of a hospitalization, what this is,” she said. “If I'm not really admitted, what am I doing in the hospital?”

Indeed. This is legislation all our federal officials should join together in a spirit of unity and support in either the closing days of the current Congress or in the earliest days of the new one.

People who need hospitalization are, in essence, being victimized. It needs to stop.

In the meantime, if you're facing a hospital stay, it's imperative you ask whether you're inpatient or outpatient.

“Observation” means outpatient.

And ask what's covered and what's not before being admitted.

Sadly, until this fix is law, you'll have to watch your wallet and your health even more carefully.