{"id":11200,"date":"2018-12-03T19:50:50","date_gmt":"2018-12-03T19:50:50","guid":{"rendered":"https:\/\/hammerle.com\/?p=11200"},"modified":"2025-06-18T17:32:01","modified_gmt":"2025-06-18T22:32:01","slug":"a-discharge-dilemma-successful-medicare-appeals-are-rare","status":"publish","type":"post","link":"https:\/\/hammerle.com\/legaltalk\/wills-trusts\/a-discharge-dilemma-successful-medicare-appeals-are-rare\/","title":{"rendered":"A Discharge Dilemma: Successful Medicare Appeals are Rare"},"content":{"rendered":"<h3>Here is a bit of information that you might find helpful if you are on Medicare and about to get inappropriately discharged from the hospital.<\/h3>\n<p>If you are on <a href=\"https:\/\/hammerle.com\/blog\/medicare-cost-sharing-numbers-for-2019\/\">Medicare<\/a>, then you can stay in the hospital only if there is a good medical reason.\u00a0 \u00a0When your doctor, or the hospitalist if your doctor is not overseeing your care during your hospital stay, decides that there is no longer a good medical reason for your stay, then he or she will issue orders that you should be discharged from the hospital.<\/p>\n<h3>If you disagree with the discharge, you can appeal the hospital\u2019s discharge decision.<\/h3>\n<p><em><strong>So how do you appeal?\u00a0<\/strong><\/em> You contact your BFCC-QIO, short for <a href=\"https:\/\/www.cms.gov\/Medicare\/Appeals-and-Grievances\/MMCAG\/BFCC-QIO-Review.html\">Beneficiary and Family Centered Care-Quality Improvement Organizations<\/a>, which is the organization designated by the Centers for Medicare &amp; Medicaid Services to handle discharge appeals.<\/p>\n<p>To start the appeal process, you or your representative must call the BFCC-QIO no later than the day of the discharge and let it know that you need an \u201cexpedited determination\u201d.\u00a0 That buys you some additional Medicare coverage &#8211; you will be financially responsible only for your coinsurance and deductible until noon of the day after you receive the BFCC-QIO decision.<\/p>\n<h3>When you call, you or your representative must be available to discuss the case.\u00a0 You may also submit written evidence to back your appeal.<\/h3>\n<p>The BFCC-IO then contacts the hospital, which is required to issue a detailed notice containing your case facts and the applicable <a href=\"https:\/\/www.medicare.gov\/what-medicare-covers\">Medicare coverage rule<\/a>.\u00a0 The burden is on the hospital, not you, to produce evidence to support the discharge.\u00a0\u00a0 However, the hospital does not have to produce your entire case record, so it will send only the documents that support the discharge decision.<\/p>\n<p>You have the right to refute the hospital\u2019s documents and the doctor\u2019s opinion, but this is where reality clashes with theory.<\/p>\n<p><em>You are sick and in the hospital bed.<\/em>\u00a0 That makes it almost impossible for you to gather your own records or obtain an expert to dispute the hospitalist\u2019s opinion.\u00a0 Your medical representative is often of limited help due to the short time period or lack of experience with the medical world.<\/p>\n<p>One trick that may work is to contact your personal physician and find out if he or she will support a longer hospital stay.\u00a0 If so, then ask your personal physician to either contact the hospitalist or to write a note that you can submit to the BFCC-QIO.<\/p>\n<p>Back to the workings of the appeal &#8211; the BFCC-QIO has to issue its decision within one calendar day after it receives all requested pertinent information.<\/p>\n<p>If you disagree with the decision and appeal further, then you will be financially responsible for your continued hospital stay if you do not win.\u00a0 If you do proceed, then here are the appeal levels:\u00a0 Qualified Independent Contractor, Administrative Law Judge, Medicare Appeals Council, Federal district court.<\/p>\n<h3>The takeaway?\u00a0 A Medicare appeal may buy you 1 or 2 extra days, but the chances of winning are slim.<\/h3>\n<p><em>Virginia Hammerle, Managing Attorney for Hammerle Morris Law Firm, has been recognized from 2012-2018 as a Super Lawyer, a Thompson Reuters Publication.\u00a0 See hammerle.com for her blog and newsletter sign-up.\u00a0 This column does not constitute legal advice.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Here is a bit of information that you might find helpful if you are on Medicare and about to get inappropriately discharged from the hospital. If you are on Medicare, then you can stay in the hospital only if there is a good medical reason.\u00a0 \u00a0When your doctor, or the hospitalist if your doctor is [&hellip;]<\/p>\n","protected":false},"author":5,"featured_media":11749,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_links_to":"","_links_to_target":""},"categories":[42],"tags":[747],"class_list":{"0":"post-11200","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-wills-trusts","8":"tag-beneficiaries"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>A Discharge Dilemma: Successful Medicare Appeals are Rare - Hammerle Morris Law Firm<\/title>\n<meta name=\"description\" content=\"Medicare patients can stay in the hospital only if there is a good medical reason. 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