Bill would correct post-hospitalization Medicare loophole

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A bipartisan group of House and Senate members have proposed legislation that would ensure that seniors have access to skilled nursing care after being hospitalized for observation.

Provider groups, including the American Health Care Association, applauded the legislation.

The bill, Improving Access to Medicare Coverage Act of 2011, tweaks the Social Security Act so that seniors' time spent under observation status at a hospital would satisfy the three-day stay skilled nursing requirement for Medicare coverage. Currently, in order to have skilled nursing care after a hospitalization, a Medicare beneficiary must be considered a hospital inpatient. If the patient is admitted for an observation stay, Medicare can deny coverage and the patient must pay out-of-pocket for subsequent nursing home care.

Sen. John Kerry (D-MA) and Sen. Olympia Snowe (R-ME) introduced the Senate version of the bill, and Rep. Joe Courtney (D-CT) and Tom Latham (R-IA) introduced the House version.

"This common sense change will ensure that seniors no longer face thousands of dollars in bills for skilled care because of an arbitrary federal policy," said Courtney. "There are no two ways about it: Three days in the hospital are three days in the hospital. Anyone who meets that threshold should receive the same benefit from Medicare."

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