Who must sign the Medicare Outpatient Observation Notice?

• A. The Physician
• B. The Nurse
• C. The Patient
• D. The Hospital Administrator

Answer: (C)

The key idea is that the signing authority for the Medicare Outpatient Observation Notice is the patient themselves, or their designated representative if the patient cannot sign. The MOON is a formal acknowledgment that the patient has received and understood their status as being in observation rather than admitted, along with the potential financial and coverage implications. Because the notice is about the patient’s understanding and consent to this status, the patient (or their representative) must sign to document receipt and comprehension. The physician, nurse, or hospital administrator can provide information and explain the notice, but they are not the required signatory for acknowledgment. If the patient is unable to sign, a legally authorized representative may sign on the patient’s behalf.