Medicare AdvantageAdministrativeMedium impact
Hospitals Must Provide Notice to Members Under Outpatient Observation for More Than 24 Hours
BCBS Texas·TX · Emergency Medicine, Critical Care·General
Effective date
Jan 23, 2025
We identified it
Jan 12, 2026
Summary
Hospitals and critical access hospitals must now provide standardized Medicare Outpatient Observation Notice to Blue Cross Medicare Advantage members who are under outpatient observation for more than 24 hours. The notice must be completed within 36 hours of observation start and requires verbal explanation, member signature, and documentation in medical records.
Action Required
Immediately: Hospital billing and nursing staff must download the Medicare Outpatient Observation Notice from CMS website, implement workflow to identify Medicare Advantage members in observation >24 hours, provide verbal explanation and obtain signatures within 36 hours of observation start, and document all communications in patient records. Staff must also update EMR templates to track notification compliance.