You do need a local attorney or to consult with the attorneys at the Legal Center for People with Disabilities and the Elderly on Sherman Street in Denver, CO. Based on your condition, it is expected that you fall under the provisions of the American with Disabilities Act (ADA) and its protections. They are the experts in the field of the ADA and will also investigate allegations of withholding medications and abuse of the disabled or elderly criminally (with the assistance of the Colorado Attorney General's Office).
The information provided in this answer does not create an attorney-client relationship. If you are interested in his legal services, feel free to call Chris at (303) 409-7635 at his law office in the Denver Tech Center. All initial consultations are free of charge.
Fighting a Hosptial Discharge
If you are admitted to a hospital as a Medicare patient, the hospital may try to discharge you before you are ready. While the hospital can't force you to leave, it can begin charging you for services. Therefore, it is important to know your rights and how to appeal. Even if you don't win your appeal, appealing can buy you crucial extra days of Medicare coverage.
Starting July 1, 2007, new notice requirements for Medicare patients being discharged from the hospital go into effect. The notices give Medicare patients information about their discharge and appeal rights. Previously hospitals were required to give patients a written notice before discharge called "Hospital-Issued Notice of Non-Coverage" (HINN). Hospitals may still give HINNs in certain circumstances, but the new rules require hospitals to give two notices to patients of their rightsone right after admission and one before discharge.
Within two days of admission to a hospital, the hospital must give you a notice called "An Important Message from Medicare about Your Rights" (IM) explaining your discharge and appeal rights. You must read the notice, sign it, and date it. Two days before discharge, the hospital must give you another copy of the IM. If you are in the hospital for three days or less, the hospital only needs to give you one notice.
Once you receive a discharge decision and you are not ready to leave, you should immediately contact your local Medicare Quality Improvement Organization (QIO). A QIO is a group of doctors and other professionals who monitor the quality of care delivered to Medicare beneficiaries. They are paid by the federal government and not affiliated with a hospital or HMO. The phone number should be on the IM.
It is very important to contact the QIO right away. You must contact the QIO by noon on the first business day after you receive the discharge notice. If you do this, you will not have to pay for your care while you wait for your discharge to be reviewed. If you don't contact the QIO by noon, the hospital can begin charging you on the third day after you receive the discharge notice.
Once you request a QIO review, the hospital is required to give you a "Detailed Notice of Discharge." You should receive the notice no later than noon the day after you request a QIO review. The detailed notice explains the medical reason behind the discharge.
The QIO will conduct a review of the discharge. The QIO doctors will review the medical necessity, appropriateness, and the quality of hospital treatment furnished to you. The hospital cannot discharge you while the QIO is reviewing the discharge decision, and you will not have to pay for the additional days in the hospital. If you don't agree with the QIO's decision, you can ask it to reconsider. It must issue a decision within three days.
If, after the reconsideration, the QIO still agrees with the hospital's decision, you can appeal to an administrative law judge (ALJ). You will probably need legal counsel to help you through this process. You can appeal the ALJ's decision to the Department of Health and Human Services, Departmental Appeals Board (DAB). Finally, if you don't agree with the DAB decision, you can appeal to federal court as long as at least $1,000 is at stake.
States may have their own discharge protections. You can find the law in your state from the QIO in your state. Click here for a list of QIOs by state.
The materials available at this web site are for informational purposes only and not for the purpose of providing legal advice. You should contact your attorney to obtain advice with respect to any particular issue or problem. Use of and access to this Web site or any of the e-mail links contained within the site do not create an attorney-client relationship between Howard Roitman, Esq. and the user or browser. The opinions expressed at or through this site are the opinions of the individual author and may not reflect the opinions of the firm or any individual attorney.
I would suggest that you consult with a local attorney to review the relevant details of your situation and discuss how you protect yourself. I hope you found my response helpful.
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