Tuesday, March 14, 2017

Bipartisan Bill to Fix Observation Stays Issue Reintroduced in Congress

Dana Halvorson 


Last week, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) commended several members of Congress for reintroducing the Improving Access to Medicare Coverage Act of 2017 (S. 568/H.R. 1421). Introduced on March 8, 2017 by Congressmen Joe Courtney (D-CT) and Glenn “GT” Thompson (R-PA) and Senators Sherrod Brown (D-OH), Susan Collins (R-ME), Bill Nelson (D-FL) and Shelley Moore Capito (R-WV), the 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. The Observation Stays Coalition, which consists of 31 organizations including AHCA/NCAL, fully supports this legislation.


AHCA/NCAL continues to keep the observation stays issue one of its top advocacy and outreach priorities. 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 the observation stays issue, please visit the AHCA/NCAL website.
You also might be interested to read this Journal of Hospital Medicine March 2017 editorial entitled Medicare and the 3-Inpatient Midnight Requirement: A Statute in Need of Modernization written by Representative Joe Courtney and Dr. Ann M. Sheehy of the University of Wisconsin School of Medicine and Public Health.

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