1Requiring a hospital to provide notice to a patient of the
2patient's outpatient status, billing implications and the
3impact of the outpatient status on insurance coverage.

4The General Assembly of the Commonwealth of Pennsylvania
5hereby enacts as follows:

6Section 1. Short title.

7This act shall be known and may be cited as the Hospital
8Observation Status Consumer Notification Act.

9Section 2. Definitions.

10The following words and phrases when used in this act shall
11have the meanings given to them in this section unless the
12context clearly indicates otherwise:

13"Hospital emergency room." An entity within a hospital which
14is organizationally distinct from other outpatient facilities
15and whose primary function is to provide emergency accident and
16emergency medical or surgical care.

1Section 3. Patient notice of observation services.

2(a) Duty.--Within 90 days of the effective date of this
3section, a hospital shall provide oral and written notice to a
4patient of the patient's outpatient status, the billing
5implications of the outpatient status and the impact of the
6outpatient status on the patient's Medicare, Medicaid and
7private insurance coverage for the current hospital services,
8including medications and other pharmaceutical supplies and
9coverage for a subsequent discharge to a skilled nursing
10facility or home-based and community-based care if all of the
11following apply:

12(1) The patient receives onsite services from the
13hospital for more than 23 consecutive hours.

14(2) The onsite services received by the patient include
15a hospital bed and meals that have been provided in an area
16of the hospital other than the hospital emergency room.

17(3) The patient has not been formally admitted as an
18inpatient at the hospital.

19(b) Contents.--The notice under subsection (a) shall include
20disclosure of the cost and ramification of the patient's status
21under subsection (a) and the patient's rights of appeal in
22regard to outpatient status.

23(c) Signature.--The written notice must be signed by the
24patient or the patient's legal representative to acknowledge

26Section 4. Training.

27A hospital shall provide training to each staff person that
28communicates outpatient status, billing implication of the
29outpatient status and the impact of the outpatient status on the
30patient's eligibility for Medicare so that a staff person can

1adequately respond to inquiries regarding the communication made
2by a patient and the patient's family.

3Section 5. Expiration.

4(a) Notice.--If the Federal Government amends 42 CFR
5409.30(a)(1) (relating to basic requirements) to eliminate or
6modify the Medicare three-day qualifying hospital stay
7requirement in a manner that makes the notification required
8under section 3 unnecessary, the Secretary of Health shall
9submit notice of the amendment for publication in the
10Pennsylvania Bulletin.

11(b) Time.--This act shall expire upon publication of the
12notice under subsection (a).

13Section 40. Effective date.

14This act shall take effect July 1, 2014, or immediately,
15whichever is later.