Patient Retains Important Rights Under New System

While Medicare’s new cost containment program has produced major changes in the way the federal government reimburses hospitals for treating the elderly, patients still have important rights, and the new system does not directly override the traditional doctor-patient relationship.

Doctors retain authority to decide when to discharge elderly patients. It is not up to the hospital or the Medicare system.

“It’s not the federal government that’s telling people they have to go home,” said Carolyne K. Davis, who runs the Medicare programs as head of the federal Health Care Financing Administration.

Doctor Signs Discharge

“I don’t sign a release form,” she said. “It’s the doctor who signs the discharge.”

Nor does the new reimbursement system obligate hospitals to send elderly persons home after a fixed number of days.

If you are an elderly person in a hospital and you do not feel well enough to go home, tell the doctor. The doctor will tell you when medical judgment indicates you are able to go home.

If you disagree, you may insist on staying another 48 hours, with your expenses covered by Medicare, after the doctor says that you can be safely discharged.

If you still wish to stay after this period, Medicare no longer covers your costs, and the hospital can bill you personally for all costs.