Washington, DC – U.S. Senator Sheldon Whitehouse (D-RI) joined Senators Sherrod Brown (D-OH), and Susan Collins (R-ME) to introduce new bipartisan legislation that would update a current loophole in Medicare policy to help protect seniors from high medical costs for the skilled nursing care they require after hospitalization. The Improving Access to Medicare Coverage Act would allow for the time patients spend in the hospital under “observation status” to count toward the requisite three-day hospital stay for coverage of skilled nursing care.
Under the current Medicare policy, a beneficiary must have an “inpatient” hospital stay of at least three days in order for Medicare to cover post-hospitalization skilled nursing care. Patients that receive hospital care under “observation status” do not qualify for this benefit, even if their hospital stay lasts longer than three days.
“Bureaucratic technicalities should be the last thing Rhode Island seniors have to worry about if they end up in the hospital. Our bipartisan Improving Access to Medicare Coverage Act would correct a loophole in billing rules that forces patients into longer, unnecessary hospital stays, allowing seniors to focus on getting back on their feet,” said Whitehouse.
The Improving Access to Medicare Coverage Act would amend Medicare law to count a beneficiary’s time spent in the hospital on “observation status” towards the three-day hospital stay requirement for skilled nursing care. The bill would also establish a 90-day appeal period following passage for those that have a qualifying hospital stay and have been denied skilled nursing care after January 1, 2024.
The legislation is also endorsed by AARP, ADVION, AMDA, American Academy of Emergency Medicine, American College of Emergency Physicians, American Geriatrics Society, American Medical Association, APTA, Association of Jewish Aging Services, Catholic Health Association of the United States, Justice in Aging, LeadingAge, Lutheran Services in America, National Center for Assisted Living, National Committee to Preserve Social Security and Medicare, and Society of Hospital Medicine.
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