Berwick urges administration to dump Medicare rehab rule

Former Medicare chief Donald Berwick, MD, said Obama administration officials should abandon a rule that leaves many older Americans without coverage for expensive rehabilitation care after they leave the hospital. The Medicare rule requires recipients to be admitted as a hospital inpatient for at least three days before the federal health insurance program for seniors and the disabled will pay for follow-up nursing home care.

An increasing number of patients are spending days in the hospital under “observation” status, often without realizing they were never admitted. Medicare does not cover the cost of nursing home care in these cases, and neither do most supplemental insurance policies, advocates say. “The patient ends up holding the bag and that’s not fair or appropriate,” Berwick, a candidate for governor of Massachusetts, said in an interview with the Boston Globe last week.