Introduction of the Improving Access to Medicare Coverage Act

Floor Speech

* Mr. COURTNEY. Madam Speaker, today on the eve of Medicare's 45th anniversary, I rise to recognize the tireless work and fierce vigilance of an organization that has prioritized the care needs of Medicare beneficiaries, the Center for Medicare Advocacy, as well as bring to light a coverage issue that the agency has been worked on for years: lengthy hospital observation stays.

* Earlier this summer, I had discussions with leaders of the Center for Medicare Advocacy about lengthy hospital observation stays which has inhibited care for Medicare beneficiaries. Excessive time on hospital observation status has been shown to create two potential problems for Medicare beneficiaries. First, prescription drugs administered in the hospital during an observation stay are not included in the inpatient deductible cap, which can easily become unaffordable for patients and their families if the medications are not included in the beneficiary's Part D formulary. Secondly, time spent on observation status in a hospital is not counted towards the three-day inpatient hospital stay required for the beneficiary to receive skilled nursing care. Both potential consequences create financial and care burdens for Medicare beneficiaries.

* Earlier in the month, I met with the Renshaw family from my district that had been negatively affected by a lengthy hospital observation status. After falling and breaking his hip, Mr. Renshaw, an elderly Medicare beneficiary, was taken to a local hospital treatment where he was subsequently put on observation status. He remained in the hospital for four days. After he was released, Mr. Renshaw required skilled nursing care for his rehabilitation. However, because Mr. Renshaw was placed on observation status instead of admitted officially as an inpatient, his time in the hospital did not count towards the Medicare three-day hospital stay required for skilled nursing care. His family was forced to write a check for nearly $10,000 in order to get him the care that he needed because Medicare would not cover this benefit.

* In response to the Center for Medicare Advocacy's vigilance on this issue and the experiences shared with me by the Renshaw family, I am introducing the Improving Access to Medicare Coverage Act. My legislation will fix this unfair component of Medicare law that arbitrarily differentiates between patients on inpatient versus observation status with obtaining necessary skilled care. The Improving Access to Medicare Coverage Act will count a beneficiary's time on observation towards the three-day hospital stay requirement for skilled nursing care. And while my legislation does not address the challenges associated with unaffordable out-of-pocket prescription drug and other costs associated with lengthy hospital observation stays, I look forward to working with the Center for Medicare Advocacy on finding a long-term solution to this urgent problem.

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