Is it against the law to have a patient pay a nursing home bill if the nursing home didnt get pre approval to switch the patient from hospice to skilled nursing?

Get Legal Help Today

 Secured with SHA-256 Encryption

Is it against the law to have a patient pay a nursing home bill if the nursing home didnt get pre approval to switch the patient from hospice to skilled nursing?

My mom was put in a nursing home under hospice but she
got well enough to take her off hospice and into skilled
nursing with the intent of bringing her home. All of her
therapies were paid but her room was not because there
was not pre approval to move her from hospice into skilled
nursing. The insurance company says that the nursing
home dropped the ball and they were well aware that there
should have been pre approval and that it is against the law
to put that amount on the patient. Is this fact?

Asked on June 25, 2018 under Business Law, Pennsylvania

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 3 years ago | Contributor

No, it is not against the law, the same as it is not against the law to have a patient pay an emergency room, a hospital, a clinic, a doctor, etc. bill if it was not pre-approved or otherwise covered. A patiient is liable for his/her medical or nursing home costs; if the patient incurs the cost before confirming that they are approved for the service or that the service is covered by some form of insurance or payment source, the patient is resonsible for the bill.


IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although AttorneyPages.com has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.

Get Legal Help Today

Find the right lawyer for your legal issue.

 Secured with SHA-256 Encryption