Industry advocates are praising proposed legislation that says patients under “observation status” at a hospital would be eligible to satisfy Medicare’s three-day requirement necessary for skilled nursing coverage.
A beneficiary currently must spend a trio of consecutive days for the federal payment program to cover skilled nursing facility care. However, patients are increasingly being held as outpatients, which is leading them to either return home early, or receive astronomical bills for care.
A bipartisan group of legislators have now introduced bills in both the Senate and House and senate to bulldoze this impediment.
“This arbitrary gap in Medicare coverage is a crisis waiting to happen for so many families in eastern Connecticut and across the country,” Rep. Joe Courtney (D-CT) said in a statement. “Whether a patient is in the hospital for three days as an inpatient, or for three days under ‘observation status’ – three days is three days, and quibbling over semantics should not keep Americans from accessing the care they’ve been prescribed by healthcare professionals, or force them to go into medical debt in order to cover the cost.”
SNF trade groups, which have long lobbied for this change, encouraged Congress to act swiftly.
“This bipartisan bill will help fix an outdated policy that continues to leave millions of Medicare beneficiaries surprised by thousands of dollars in medical bills and hanging with uncertainty regarding their access to the Medicare coverage they deserve,” Mark Parkinson, president and CEO of the American Health Care Association said.
“This would be the simplest and fairest way to resolve the observation days issue. LeadingAge strongly supports the legislation and we urge Congress to pass it without delay,” added President and CEO Katie Smith Sloan.
In addition to Courtney, the bills are also supported by Rep. Glenn Thompson (R-PA), a former nursing home executive, and Sen. Sherrod Brown (D-OH). The effort is endorsed by several other trade groups, including AARP, the American Association of Post-Acute Care Nursing, and the Society for Post-Acute and Long-Term Care Medicine.