1Requiring hospitals to provide certain notice of patient
2outpatient status; providing for training; imposing duties on
3the Department of Health; and providing for expiration.

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 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"Department." The Department of Health of the Commonwealth.

14"Hospital emergency room." An entity within a hospital,
15organizationally distinct from other outpatient facilities, the
16primary function of which is to provide emergency accident and
17emergency medical or surgical care.

18Section 3. Consumer notification.

1(a) General rule.--A hospital shall provide oral and written
2notice to a patient of the patient's outpatient status, the
3billing implications of the outpatient status and the impact of
4the outpatient status on the patient's Medicare, Medicaid or
5private insurance coverage for the current hospital services,
6including medications and other pharmaceutical supplies, as well
7as coverage for any subsequent discharge to a skilled nursing
8facility or home and community-based care if:

9(1) The patient receives on-site services from the
10hospital for more than 23 consecutive hours.

11(2) The on-site services received by the patient include
12a hospital bed and meals that have been provided in an area
13of the hospital other than the hospital emergency room.

14(3) The patient has not been formally admitted as an
15inpatient at the hospital.

16(b) Signature required.--The written notice shall be signed
17by the patient or the patient's legal representative to
18acknowledge receipt.

19Section 4. Training.

20A hospital shall provide training to staff persons who
21communicate outpatient status, billing implication of the
22outpatient status and the impact of the outpatient status on a
23patient's eligibility for Medicare so that the staff persons can
24adequately respond to patients and their families' inquiries
25regarding the communications.

26Section 5. Duty of department.

27Within 30 days from the effective date of this section, the
28department shall convene a meeting with consumers, advocacy
29organizations and other interested stakeholders to solicit input
30on the consumer notification required under section 3(a).

1Section 6. Duty of hospitals.

2Within 60 days from the completion of the meeting under
3section 5 or 90 days from the effective date of this section,
4whichever is sooner, hospitals shall utilize the input received
5under section 5 and provide consumer notification as required
6under section 3. The notice shall include, at a minimum,
7disclosure of the costs and ramifications of their status as
8outlined in section 3(a) and the patient's rights of appeal
9relating to the patient's outpatient status.

10Section 7. Notice in Pennsylvanian Bulletin.

11Within ten days of action taken by the Federal Government to
12amend 42 CFR § 409.30(a)(1) to either eliminate or modify the
13Medicare three-day qualifying hospital stay requirement in a
14manner that makes the notification in this act unnecessary, the
15department shall publish a notice in the Pennsylvania Bulletin
16that reports the action.

17Section 8. Expiration.

18This act shall expire on the date the notice in section 7 is
19published.

20Section 9. Effective date.

21This act shall take effect on July 1, 2014, or immediately,
22whichever is later.