The nation’s largest advocacy group for seniors, AARP, is again joining providers in pushing Congress to eliminate the three-day requirement that patients must meet before Medicare coverage for a skilled nursing facility kicks in.
In a letter to the four sponsors of the “Improving Access to Medicare Coverage Act of 2023,” AARP’s Senior Vice President for Government Affairs Bill Sweeney endorsed the bill, noting that many seniors wind up with “surprise medical bills” for the full cost of care.
“Unfortunately, the financial impact for Medicare beneficiaries who spend time in observation can be burdensome and significant,” Sweeney wrote. “These beneficiaries may be faced with paying thousands of dollars in surprise medical bills for the full cost of their SNF care or the denial of appropriate SNF care due to lack of Medicare coverage. In some cases, Medicare beneficiaries may forego the necessary follow-up care they need, such as therapies in SNFs, due to the cost of care.”
AARP, which represents more than 100 million Americans age 50 or older, commended the two Republican and two Democrat lawmakers who reintroduced the bipartisan bill.
The legislation has been reintroduced several times, and backers, which includes more than 30 national organizations representing seniors and senior-care facilities, hope that this time, they succeed.
The reintroduced bill would apply days spent in the hospital under observation status toward the three-day hospital stay requirement for Medicare to kick in. Currently, traditional Medicare does not count observation time toward that requirement.
Both LeadingAge and the American Health Care Association/National Center for Assisted Living have endorsed the legislation.
“Seniors who spend three days in a hospital, regardless of their inpatient or observation designation, must be able to recover safely in a skilled nursing facility when they need it without fear of considerable out-of-pocket costs,” Mark Parkinson, president and CEO of AHCA/NCAL has previously said. “It’s time to eliminate this confusing, costly policy and barrier to post-acute care, and this legislation will best serve our Medicare beneficiaries as well as the Medicare Trust fund.”
A recent study of waivers of the three-day stay requirement by the Centers for Medicare & Medicaid Services found that waivers did not increase costs or lead to poor outcomes. CMS’ Innovation Center’s analysis found that SNF length of stay and long stays both decreased.
The 2023 legislation, HR 5138, has been referred to the US House Committees on Ways and Means and Energy and Commerce. Neither has scheduled hearings on the bill yet.
