WASHINGTON, D.C. – U.S. Senator Sherrod Brown (D-OH) introduced legislation this week to fix an arbitrary Medicare policy that excludes coverage of skilled nursing care. Under current Medicare policy, a beneficiary must have an “inpatient” hospital stay of at least three days in order for Medicare to cover skilled nursing care. Patients that receive hospital care on “observation status” do not qualify for this benefit, even if their hospital stay lasts longer than three days.
“When seniors are transferred from a hospital to a nursing home for further care they should be able to focus on their recovery instead of technicalities that could lead to sky high medical bills,” said Brown. “This bill would help ensure that seniors receive the care they need without incurring unexpected and unfair costs.”
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.
The bipartisan bill, which was co-introduced by U.S. Congressmen Joe Courtney (D-CT) and Tom Latham (R-IA), is endorsed by the following groups:
AARP, American Medical Association (AMA), American Health Care Association (AHCA), the Center for Medicare Advocacy, American Case Managers Association, American Medical Directors Association (AMDA), American Nurses Association (ANA), LeadingAge, National Association of Professional Geriatric Care Managers, National Committee to Preserve Social Security and Medicare, Society of Hospital Medicine
The legislation 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;
- 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, 2013.