NASGA Legislative Liaison Brenda Kelly Nelum Interviewed by NBC Nightly News: Law Aims to Protect Medicare Patients from Surprise Hospital Bill

M.J. Bricout of Texas is still paying off a $28,000 medical bill.

Three years ago, M.J. Bricout broke her leg. And then when she got to the hospital she says she was robbed.

"I was mugged. I feel like it's an appropriate word to use," said Bricout, who got socked with a $28,000 bill because her doctor categorized her as "under observation" instead of as an "inpatient" before she went into two months of rehab.

But on Wednesday, three years after NBC News first told Bricout's story, a new law goes into effect that requires hospitals to tell people orally and in writing that they are "under observation," effectively outpatients, and thus potentially liable for much larger bills that aren't covered by Medicare. More than 1 million patients will get these MOONs (Medicare Outpatient Observation Notices) every year, according to federal estimates.

Rep. Lloyd Doggett, D.-Texas, who co-wrote the Congressional bill that created the law, said two Nightly News reports on Bricout and others like her in 2014 inspired him to push for change.

Three years ago, M.J. Bricout broke her leg. And then when she got to the hospital she says she was robbed.

"I was mugged. I feel like it's an appropriate word to use," said Bricout, who got socked with a $28,000 bill because her doctor categorized her as "under observation" instead of as an "inpatient" before she went into two months of rehab.

But on Wednesday, three years after NBC News first told Bricout's story, a new law goes into effect that requires hospitals to tell people orally and in writing that they are "under observation," effectively outpatients, and thus potentially liable for much larger bills that aren't covered by Medicare. More than 1 million patients will get these MOONs (Medicare Outpatient Observation Notices) every year, according to federal estimates.

Rep. Lloyd Doggett, D.-Texas, who co-wrote the Congressional bill that created the law, said two Nightly News reports on Bricout and others like her in 2014 inspired him to push for change.

"In times of sickness and stress, patients should be focused on recovery, not unexpected threats to their bank account," Rep. Doggett told NBC News. "Now, patients will be armed with the knowledge they need to be their own best advocates."

What the new law does not do, however, is eliminate the loophole altogether. A bill reintroduced Wednesday by Congressman Joe Courtney, D-Connecticut, would make days spent "under observation" count towards qualification for Medicare coverage.

Brenda Kelley Nelum successfully challenged a five-figure medical bill.

[NASGA Legislative Liaison] Brenda Kelley Nelum of Virginia fought her husband's designation as "under observation" instead of "inpatient." Had she not succeeded, "It would have been a major hardship," she said. She and her husband, who later passed away, would've owed as much as $30,000 for 30 days of rehab.

"We would have been broke."

Full Article and Source:
Law Aims to Protect Medicare Patients From Surprise Hospital Bill

See Brenda's Original Interview in 2014:
How to Avoid Two Words That Cost Thousands in Medicare Bills

Brenda and her husband, Doc Nelum