The development of the MOON (Medicare Outpatient Observation Notice) form and subsequent implementation by hospitals has raised a number of different questions particularly the exact difference in determining inpatient status versus outpatient observation. This workshop explores some of implementation processes for issuances of the MOON form and the questions that may be raised by Medicare beneficiaries and/or their families. Competent personnel who are knowledgeable about the form, explanation of the notice and the attendant questions are all discussed. Careful development of written policies and implementation procedures is a must in this area. Proper compliance is a difficult goal, and litigation at some level should be anticipated in the future.