RM, Rep. Joe Courtney, D-Conn.

Long-running efforts to allow hospitalized patients classified under “observation status” to satisfy Medicare’s three-day requirement may have new life, according to a key Democratic lawmaker.

Rep. Joe Courtney (D-CT) said he believes Democrats’ takeover of the House may finally “give oxygen” to the effort, after he reintroduced legislation to bulldoze this impediment to skilled care. President Trump recently expressed a desire to stop providers from issuing unexpected medical bills, and Courtney labeled some of the tricks played using observation status as “surprise billing on steroids.”

The Connecticut congressman made his comments on Thursday during the Center for Medicare Advocacy’s annual summit in Washington, D.C. He expects to have a partner on his legislation in the House Ways and Means health subcommittee in Chairman Lloyd Doggett (D-TX). The Texas lawmaker previously championed the Notice of Observation Treatment and Implication for Care Eligibility Act that requires hospitals to give beneficiaries a notice explaining their observation status, Inside Health Policy reported Friday.  

Courtney said Thursday that Doggett has made the “strongest possible” commitment that the subcommittee is “going to give this oxygen” and hold a hearing on the legislation, which has not happened before. Doggett has also indicated willingness to have the bill scored by the Congressional Budget Office, another impediment to past efforts.

A beneficiary currently must spend a trio of consecutive days as a hospital inpatient before Medicare covers skilled nursing facility care. However, patients are increasingly being held as outpatients under observation status, which is leading them to either return home early or receive astronomical bills for care. Nursing home industry advocates have for years fought to end this practice. They support Courtney’s bill.

The Center for Medicare Advocacy also supports the measure and is currently fighting Health and Human Services in court over the three-day rule.