Congress Introduces Legislation to Ensure Medicare SNF Coverage and Stop Surprise Billing

March 14, 2019
Policy Snapshot

Reps. Joe Courtney (D-CT) and Glenn ‘GT’ Thompson (R-PA), and Sen. Sherrod Brown (D-OH) reintroduced bipartisan, bicameral legislation to fix an arbitrary Medicare policy that excludes coverage of skilled nursing care for certain patients, resulting in exorbitant and unexpected out-of-pocket costs. The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682 & S. 753) would ensure Medicare covers doctor-recommended post-acute care by counting the time spent under “observation status” toward the requisite three-day hospital stay for coverage of skilled nursing care.

Under current Medicare policy, a beneficiary must have an “inpatient” hospital stay of at least three days for Medicare to cover skilled nursing care. However, patients are increasingly being held under “observation status,” an “outpatient” designation. Patients who receive hospital care on “observation status” do not qualify for the benefit of skilled nursing care, even if their hospital stay lasts longer than three days. These patients are either forced to return home without the treatment their care team has suggested, or, as often happens, are billed astronomical amounts after their stays in a skilled nursing facility (SNF). These patients can easily accrue tens of thousands of dollars in SNF bills.

The Society has supported this legislation when previously introduced and works with a large coalition of groups advocating for its passage.

Help urge Congress to pass H.R. 1682 and S.753 by clicking here to send a message with the Society’s grassroots network to your elected officials.