Congressman Joe Courtney (D-CT), Congressman Tom Latham (R-IA), and Senator Sherrod Brown (D-OH) introduced The Improving Access to Medicare Coverage Act in the House (H.R. 1179) and the Senate.
This legislation is designed to fix the Medicare policy that excludes coverage of skilled nursing care for individuals on “observation status.” Current Medicare policy dictates that a beneficiary must have an “inpatient” hospital stay of at least three days in order for Medicare to cover skilled nursing care. Patients that receive hospital care on “observation status” do not qualify for this benefit, even when their hospital stay lasts longer than three days.
This new legislation will change this arbitrary policy and allow the time spent in the hospital under “observation status” to count toward the requisite three-day hospital stay for coverage of skilled nursing care. The legislation will also establish a 90-day appeal period for those that have a qualifying hospital stay and have been denied skilled nursing care after January 1, 2013.