A health care entity, as defined in section 1718‑B, subsection 1, paragraph B, shall disclose to a patient who is covered by the federal Medicare program and who is on observation status and not an admitted patient at the health care entity the following information in a single notice:
1. Medicare outpatient observation notice. The Medicare outpatient observation notice required under 42 Code of Federal Regulations, Section 489.20(y);
2. Impact on patient's financial liability. Notification that observation status may have an impact on the patient's financial liability; and
3. Opportunity to discuss potential financial liability. Notification that the patient may meet with a representative from the health care entity's financial office to discuss the patient's potential financial liability.