H.R. 876, Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act

H.R. 876

Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act

Rep. Lloyd Doggett
Ways and Means

March 16, 2015 (114th Congress, 1st Session)

Staff Contact

Floor Situation

On Monday, March 16, 2015, the House will consider H.R. 876, the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act, under a suspension of the rules.  H.R. 876 was introduced on February 11, 2015 by Rep. Lloyd Doggett (D-TX) and referred to the Committee on Ways and Means.

Bill Summary

H.R. 876 amends title XVIII of the Social Security Act to require hospitals to provide written and oral notification to patients who are in the hospital under observation for more than 24 hours.  Within 36 hours, the hospital is required to provide notification which: 1) explains the individual’s status as an outpatient under observation and not as an inpatient; 2) explains the reason for that classification; 3) explains the implications of that outpatient status on eligibility for Medicare coverage of items and services as well as cost-sharing requirements; 4) includes the name and title of the hospital staff who gave an oral notification and its date and time; and 5) is signed by the individual to acknowledge its receipt.


Currently, a hospital may either admit a patient as an “inpatient” or keep the patient “under observation.”[1]  “While the distinction is often impossible to determine, particularly by the beneficiary, the economic implications can be extreme if the patient later requires care in a skilled nursing facility.”[2]  Medicare pays for skilled nursing care for a beneficiary for more than three days as an “inpatient” but does not pay if the beneficiary was in the hospital “under observation.”[3]  This legislation would alert the beneficiary of the financial implications of that classification.

[1] http://toddyoung.house.gov/press-releases/rep-lloyd-doggett-rep-todd-young-introduce-bipartisan-legislation-to-protect-medicare-beneficiaries/
[2] See Id.
[3] See Id.


CBO estimates that enacting this legislation would not have significant budgetary effects over the 2015-2025 period.

Additional Information

For questions or further information contact the GOP Conference at 5-5107.