April 26, 2024
This week, Senators Sherrod Brown (D-OH), Susan Collins (R-ME) and Sheldon Whitehouse (D-RI) announced bipartisan legislation to 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 (S. 4137) 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.
Specifically, the bill 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; and
- 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 Society supports the legislation and is ready to work with the bills co-sponsors to help its passage.