Friday, September 20, 2013

McDermott Introduces Fairness for Beneficiaries Act of 2013

On Thursday, Rep. Jim McDermott (D-WA) introduced in the House the Fairness for Beneficiaries Act of 2013, which repeals the three-day inpatient stay Medicare requirement that beneficiaries must satisfy before they are eligible for skilled nursing care center benefits. McDermott specifically cited the work of the Commission on Long-Term Care, who last week recommended the three-day stay be eliminated, as a motivator to put the bill into play in Congress. AHCA/NCAL has long been in support of eliminating the mandatory three-day stay, and prior to introducing the bill, McDermott’s office contacted AHCA/NCAL for comments on the legislation. 

According to a press release issued yesterday, the Fairness for Beneficiaries Act of 2013 also includes protections against fraud, waste and abuse. It retains the current requirement that all skilled nursing care must be deemed medically necessary in order for patients to access the Medicare Part A benefit. The bill also requires the HHS Secretary to develop a “uniform set of criteria to support medical necessity determinations.”

AHCA/NCAL supports eliminating the three-day stay requirement and solving the related issue of observation stays. For more information about observation stays and the three-day stay requirement, visit the AHCA/NCAL website.

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