If you are hearing stories about premature hospital discharge from your Medicare clients, consider reminding them about new Medicare rules about the way hospitals discharge Medicare patients that went into effect yesterday, July 1.

As a result of litigation initiated in 2003, hospitalized Medicare patients will now be better protected against being forced out of a hospital before they can be safely cared for at home or in a nursing home.

The new regulations require that patients be given notice of their discharge rights on admission (although it can occur up to two days later) and again at least four hours before discharge. If patients or their families believe the discharge will be premature and not in a patient’s best interest, they are entitled to an expedited review of the discharge decision. If they request an expedited review, the patient can remain in the hospital without charge at least until noon of the day following an independent agency’s review.

The independent review agency is called a Quality Improvement Organization (QIO), and the patient must get in touch with its staff by phone or in writing before the close of business on the day the hospital plans to send the patient home. The QIO demands that the hospital give the patient a detailed, written explanation of her medical condition and the basis for the proposed discharge. The hospital has until noon the day after the QIO is contacted to get that information to the patient. Patients can tell the QIO about why they think discharge is a bad idea, and it will especially help for attending physicians to recommend against discharge.

If the QIO disagrees with the discharge, the patient can continue receiving care in the hospital until the hospital again proposed discharge.

To learn more, visit The Center for Medicare Advocacy at www.medicareadvocacy.org/Hospital_NewDischargeRules.htm