"We are sympathetic to and understand the implications to Medicare beneficiaries that result from extended observation services, including possible increases in out-of-pocket costs and difficulties in meeting the minimum inpatient stay requirements for skilled nursing care," she said.
"However, hospitals must operate within the policies that govern them. And we do not believe that discharging a patient from observation services at an arbitrary time limit of 48 hours is clinically appropriate, simply because the patient does not qualify for inpatient care."
More than 2,000 providers participated in the listening session. It can be heard until Sept. 8 by calling 1-800-642-1687. CMS is accepting comments in writing here.