Q: Does the Affordable Care Act require Medicare beneficiaries over age 75 to be admitted to the hospital by their primary care physician?
A. No. There is no such requirement in the law.
FULL QUESTION
Can this possibly be true?
Subject: MEDICARE AT AGE 76
Hope all of you who count of Medicare to take care of you into your golden years have a back-up plan.
If you don’t read this, and do nothing about it, don’t complain when it affects you or your loved ones!!!!!
This is the second Judge to have read the Obama Care document and made comments. More highlights of Nancy’s “pass it and then find out what’s in the bill”!!!!!!
Show this to everyone nearing the ripe old age of 76. These are just a few of the things that we Seniors are going to have to deal with starting in 2014. Even far left Democrats will not like these.
MEDICARE AT AGE 76, IMPORTANT PLEASE READ – ANYONE WHO DOUBTS THIS IS TRUE CAN DOWNLOAD THE NEW OBAMACARE AND LOOK UP THE PAGES MENTIONED. THIS IS JUST THE BEGINNING …………………. PLEASE PASS THIS OUTRAGE TO EVERYONE ON YOUR LIST!!!
THIS should be read by everyone, especially important to those over 75 ……. If you are younger, then it may apply to your parents….
Your hospital Medicare admittance has just changed under Obama Care. You must be admitted by your primary Physician in order for Medicare to pay for it! If you are admitted by an emergency room doctor it is treated as outpatient care where hospital costs are not covered. This is only the tip of the iceberg for Obama Care. Just wait to see what happens in this year and 2014!
YOU ARE NOT GOING TO LIKE THIS… At age 76 when you most need it most, you are not eligible for cancer treatment * see page 272. What Nancy Pelosi didn’t want us to know until after the healthcare bill was passed.
Remember she said, “We have to pass the Bill so that we can see what’s in it.” Well, here it is.Obama Care Highlighted by Page Number THE CARE BILL HB 3200 JUDGE KITHIL IS THE 2ND OFFICIAL WHO HAS OUTLINED THESE PARTS OF THE CARE BILL. Judge Kithil of Marble Falls, TX – highlighted the most egregious pages of HB3200. Please read this……. especially the reference to pages 58 & 59, JUDGE KITHIL wrote:
** Page 50/section 152: The bill will provide insurance to all non-U.S. residents, even if they are here illegally.
** Page 58 and 59: The government will have real-time access to an individual’s bank account and will have the authority to make electronic fund transfers from those accounts.
** Page 65/section 164: The plan will be subsidized (by the government) for all union members, union retirees and for community organizations (such as the Association of Community Organizations for Reform Now – ACORN)
** Page 203/line 14-15: The tax imposed under this section will not be treated as a tax. (How could anybody in their right mind come up with that?)
** Page 241 and 253: Doctors will all be paid the same regardless of specialty, and the government will set all doctors’ fees.
** Page 272. section 1145: Cancer hospital will ration care according to the patient’s age.
** Page 317 and 321: The government will impose a prohibition on hospital expansion; however, communities may petition for an exception.
** Page 425, line 4-12: The government mandates advance-care planning consultations. Those on Social Security will be required to attend an “end-of-life planning” seminar every five years. (Death counseling..)
** Page 429, line 13-25: The government will specify which doctors can write an end-of-life order.
HAD ENOUGH???? Judge Kithil then goes on to identify: “Finally, it is specifically stated that this bill will not apply to members of Congress.
No wonder they did not see the need to read it….doesn’t apply to them!!! THE AMERICAN PEOPLE NEED TO STAND UP TO WASHINGTON …. I don’t know if we can do anything, but awareness helps.
Winds Of Change — Warren Buffet is asking each addressee to forward this email to a minimum of twenty people on their address list; in turn ask each of those to do likewise. At least 20 if you can. It has to stop somewhere.
In three days, most people in The United States of America will have this message. This is one idea that really should be passed around . . .
FULL ANSWER
Perhaps you’ve heard this one about a change in Medicare affecting seniors over 75:
Chain email : Your hospital Medicare admittance has just changed under ObamaCare. You must be admitted by your primary physician in order for Medicare to pay for it! If you are admitted by an emergency room doctor it is treated as outpatient care where hospital costs are not covered.
It’s a claim attached to the “Judge Kithil” chain email that just won’t die. But this claim — like many others in the chain email above — is wrong.
“I can say without hesitation this is false,” said Andrea Callow, a policy attorney for the nonpartisan Center for Medicare Advocacy, in an email to FactCheck.org.
Callow wrote that “nothing in the Affordable Care Act contains a requirement that a primary care physician admit a patient if they are 76 or older.” She said Medicare coverage for hospital care is based on the Social Security Act’s criteria for Medicare Parts A and B, as well as rules and guidance from the Centers for Medicare & Medicaid Services.
“There is nothing about age or PCP vs. ED doctor in the law that affects a beneficiary’s Medicare coverage,” Callow wrote, referring to a primary care physician and emergency department doctor.
In addition, a spokesman for the Centers for Medicare & Medicaid Services told us that “we know of no such provision in the ACA that required this.”
Indeed, the Medicare.gov website says that Medicare Part A covers hospital services when “a doctor makes an official order” saying you need inpatient hospital care for treatment. The website does not say that it has to be your “primary care physician,” as the email says.
Furthermore, CMS issued guidance on “Hospital Inpatient Admission Order and Certification” on Jan. 30. It covers how to submit an order for inpatient services for someone, as well as who may submit the order, as a condition of payment under Medicare Part A. The guidance does not say that a primary care physician must make the order, either.
Claim Origins
We’re not sure how this particular claim came about, but it’s not the first time we’ve heard of problems the Affordable Care Act supposedly creates for those over the age of 75.
In 2012, we wrote about a bogus claim that under the health care law “no one over 75 will be given major medical procedures unless approved by locally administered Ethics Panels.”
And the same email claiming that primary care physicians must admit patients to hospitals in order for Medicare to cover costs also says that, because of the ACA, “at age 76 when you most need it most, you are not eligible for cancer treatment.” That’s also not true.
That inaccurate claim was based on a misreading of H.R. 3200, an old House health care bill from 2009 that did not become law. David Kithil, a former judge in Burnet County, Texas, made the claim that cancer hospitals “will ration care according to the patient’s age” in a letter he had published in the River Cities Daily Tribune. He cited page 272 of the bill to support his claim about rationed cancer treatments.
But as we wrote in a lengthy analysis debunking several of the claims made in Kithil’s letter and elsewhere, page 272 of the bill merely called for a study of whether a certain class of hospitals incur higher costs than some others for the cancer care they deliver. The bill actually would’ve allowed Medicare to pay those hospitals more for their higher costs. There was no mention of denying cancer treatments for those over 75 or otherwise.
Versions of Kithil’s long since outdated letter have been forwarded widely for nearly five years now. Even he says it’s “not accurate” and he wishes it would just “die.”
Callow, of the Center for Medicare Advocacy, thinks the bogus claim about Medicare patients needing to be admitted by primary care physicians stems from a long-standing concern about how Medicare bills patients classified as “outpatients” even though they stay overnight for “observation services.”
“Your hospital status (whether the hospital considers you an ‘inpatient’ or ‘outpatient’) affects how much you pay for hospital services (like X-rays, drugs, and lab tests) and may also affect whether Medicare will cover care you get in a skilled nursing facility,” the Centers for Medicare & Medicaid Services warns in a pamphlet that urges Medicare patients to clarify their status within hours of arriving at the hospital.
Callow said the issue concerning observation care, which her organization has followed since at least 2000, also has nothing to do with the Affordable Care Act, or which physician is responsible for admitting the patient.
“If I had to wager a bet, I would say the original Judge Kithil email got jumbled with some information on observation status and this is what came out,” she said.
— D’Angelo Gore
Sources
Callow, Andrea. Center for Medicare Advocacy. Email sent to FactCheck.org. 24 Mar 2014.
Centers for Medicare & Medicaid Services. Hospital Inpatient Admission Order and Certification. 30 Jan 2014.
Centers for Medicare & Medicaid Services. “Are You a Hospital Inpatient or Outpatient?” Feb 2011. Accessed 25 Mar 2014.
Tergesen, Anne. “Beware Medicare’s ‘Observation’ Status.” Wall Street Journal. 19 Oct 2013.
Jackson, Brooks, et al. “Twenty-six Lies About H.R. 3200.” FactCheck.org. 28 Aug 2009.
Blackburn, Scott. ” ‘Death Panels’ Redux.” FactCheck.org. 20 Apr 2012.
Har, Janie. “Will seniors be denied cancer treatment under Obamacare?” PolitiFact Oregon. 8 Jun 2013.