The legislation raises questions regarding logistics.
As residents of the U.S. Southeast prepare for Hurricane Dorian, which is expected to skirt the coast today, bringing with it hurricane-force winds and storm surges, providers there have something else to worry about as well: the MOON (Medicare Outpatient Observation Notice).
As reported recently on Monitor Mondays by Ronald Hirsch, MD, Florida Gov. Ron DeSantis recently signed a bill with some interesting healthcare provisions. First, all hospitals in Florida will now need to notify all observation patients that they are in observation immediately, either with the MOON or a form to be developed by the state.
Yes, the law actually uses the word “immediately,” but of course it does not define it. We all know that the MOON is not required by federal law to be given unless 24 hours of observation services are provided, but providing it earlier is not prohibited, so this should work. It will be interesting to see what sort of form the Florida Department of Health develops.
Sunshine State hospitals also will be required to notify every patient’s primary care physician within 24 hours of admission, and at discharge, they must inform the patient that they can request that hospital physicians talk to their primary care doctor about their plan of care. Hospitals also must provide the primary care physician a discharge summary within 14 days.
Of course, doctors, not hospitals, are the ones who have to prepare the discharge summary, so it is baffling that the hospital will be held accountable if a physician does not provide the discharge summary in a timely manner. The law, HB 843, also does something that may worry some hospitals: it allows patients to spend up to 24 hours in ambulatory surgery centers (ASCs) instead of requiring discharge the same day.
This opens the door for a wider variety of patients to have surgery in an ASC, taking volume from hospitals. Will such laws spread around the country? It will be interesting to watch.
For decades, clinical documentation integrity (CDI) programs have been synonymous with inpatient care. They evolved from early efforts to improve Diagnosis-Related Group (DRG) accuracy into
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