Content of Election

40 - Content of Election (Rev. 1, 10-01-03) A3-3106.3, HO-219.3 A beneficiary's election not to use reserve days should specify the name of the hospital and the starting date of the election. Where the hospital is not reimbursed under the prospective payment system, the starting date of the election may be any day after regular benefits are exhausted. Where the hospital is reimbursed under the prospective payment system, the starting date of the election depends on whether the beneficiary has regular benefit days remaining upon entering the hospital. If the beneficiary has regular benefit days remaining upon entering the hospital on or after October 1, 1997, the starting date of the election must be the later of the first day after: (1) the charges equal the cost outlier threshold, or (2) the day regular benefits are exhausted. If the beneficiary has no regular benefits remaining upon entering the hospital, the starting date of the election must be the first day of the hospital stay. The election may specify a termination date before the last day of the stay only if the hospital is not reimbursed under the prospective payment system and the election is made effective beginning with the first day for which reserve days are available (§30.4.1). Where the hospital is under the prospective payment system, the election may not specify a termination date because the election remains in effect until the last day of the stay.