Wednesday, March 25, 2015

Observation Stays Legislation Introduced This Week

Dana Halvorson


This week, Senators Sherrod Brown (D-OH), Susan Collins (R-ME), Bill Nelson (D-FL), Shelley Moore Capito (R-WV) and Congressman Joe Courtney (D-CT-2) reintroduced the Improving Access to Medicare Coverage Act of 2015 (S. 843/H.R. 1571). This important legislation ensures that time spent under “observation status” in a hospital counts toward satisfying the three-day inpatient hospital requirement for coverage of skilled nursing care services under Medicare. Often, patients remain under ‘‘observation status’’ in the hospital for several days. These days are not counted toward the three-day inpatient stay requirement because they are considered outpatient.

Increasingly, patients have no idea what their status is in a hospital, or the importance of it, which can lead to thousands of dollars in out-of-pocket medical expenses should they need skilled nursing center care following their hospital stay. In addition to placing a financial burden on seniors and their families, this anomaly in Medicare rules can cause unnecessary spend-down, accelerating the time frame in which seniors will have to turn to programs such as Medicaid to pay for their care. For more information about observation stays and the three-day stay requirement, visit the AHCA/NCAL website.





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