Tuesday, January 31, 2017

Senate Finance Committee Tom Price Nomination Hearing and Observation Stays Issue

Dana Halvorson 

Carlos Barria | Reuters image
On Tuesday, January 24, the Senate Finance Committee held a hearing to consider the nomination of the Honorable Thomas Price to be the U.S. Secretary of Health and Human Services. U.S. Senator Sherrod Brown (D-OH), a member of the Finance Committee, submitted a question for the hearing record on the observation stays issue that AHCA/NCAL has been focused on. Specifically, the Senator noted that he had heard from too many Ohioans whose skilled nursing facility (SNF) care was not fully covered by Medicare because their hospital stays were classified as “observation” rather than inpatient. Senator Brown has introduced in the past the Improving Access to Medicare Coverage Act, which he plans to reintroduce this Congress, that would enable the time beneficiaries spend in the hospital under observation to count toward the three-day requirement for Medicare coverage.

AHCA/NCAL is in full support of the legislation, and is part of a large Coalition of national provider and beneficiary organizations advocating for its passage. The Senator asked in the hearing record that if Price is confirmed, if he will work to administratively correct this issue impacting Medicare beneficiaries. If Price is unable to address the issue administratively, that Price work with Senator Brown to pass the legislation.

Price responded to Brown's question in the hearing record with the following answer. “If confirmed, I will be pleased to work with you to further consider the necessity of the three day rule and its pros and cons. I will endeavor to work with CMS to identify what more can be done with regard to the observation status issue as well. And if the best path forward involves legislation, I would be pleased to work with you on that as well.”

AHCA/NCAL has been closely following issues relating to observation stays and the 3-day stay requirement, and their impact on Medicare SNF coverage. Please visit the AHCA/NCAL website to learn more.       

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