A bill which seeks to alleviate the “3-day stay” barrier for Medicare reimbursement in a skilled nursing facility (SNF) will be part of the focus of a Congressional hearing held this afternoon.
The legislation, the Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015 (H.R. 290), is sponsored by Rep. Jim Renacci (R-OH) and creates a quality criteria which waives the currently mandated requirement for top-performing SNFs.
Rep. Renacci, a member of the House Ways and Means subcommittee on Health—the committee which has broad jurisdiction over Medicare policy—will testify on his proposed legislation as a part of a “Member day” hearing, where Members of Congress are allowed to speak on behalf of their favored policies.
The legislation was first introduced by Rep. Renacci, a former SNF owner, as a way to ensure beneficiaries do not receive unanticipated medical expenses that are not covered by Medicare because they did not spend the required 3 days in a hospital inpatient setting before transitioning to skilled care.
SNFs increasingly serve a higher acuity population at a lower cost than a hospital setting, and often patients are discharged to a skilled setting much more rapidly than they were when the 3-day requirement was initially established.
Additionally, many patients can be placed on “observation” status in hospitals and incorrectly believe they retain their inpatient status, when they have actually been deemed outpatient. If a patient has outpatient status, their stay does not count toward the 3-day requirement, further adding to beneficiary confusion as to what constitutes as an appropriate length of hospital stay to qualify for Medicare coverage of a skilled stay.
The American Health Care Association/National Center for Assisted Living continues to support Rep. Renacci’s bill as a part of all efforts to reduce the barriers to Medicare coverage for beneficiaries in need of skilled care.