Sen. Bill Nelson (D-FL)

Medicare should cover people who go to a skilled nursing facility without a preceding hospital stay, experts recently told the Senate Special Committee on Aging.

Increasingly, hospital patients are being placed in observation status and therefore are ineligible for coverage of follow-up services, panelists noted. The “two-midnight rule” meant to reduce long observation stays is not an effective solution, several testifiers said.

A better option is to scrap the rule that people spend qualifying time as a hospital inpatient, they argued. Proposed legislation would accomplish this, and certain new payment systems already pay for SNF services without a qualifying hospital stay, they noted.