Commission on Long-Term Care Recommends Courtney-Sponsored Modifications to Three-Day Hospital Stay Requirement for Skilled Nursing Care Coverage in Medicare
Press Release
Today, Congressman Joe Courtney (CT-2) announced that a new report issued by the Commission on Long-Term Care recommends steps to protect access to skilled nursing care for Medicare beneficiaries--an objective that legislation authored by Courtney would achieve. The Improving Access to Medicare Coverage Act (H.R. 1179) would address an issue that affects thousands of Medicare beneficiaries every year.
"I am pleased to see that the observation status problem is getting the attention it deserves," Courtney said. "The Commission on Long-Term Care report underscores the need for a legislative solution that will protect Medicare beneficiaries from being left on the hook for expensive but necessary follow-up skilled nursing care after a hospital stay. My bill has received growing bipartisan support, and I am hopeful that we can move forward to protect seniors and their families from this unfortunate situation."
The report is available here (observation status is addressed on page 92):http://www.ltccommission.senate.gov/Commission%20on%20Long-Term%20Care-%20Final%20Report%209-26-13.pdf
Under current Medicare law, a beneficiary must have an inpatient hospital stay of at least three days in order for Medicare to cover skilled nursing care. Patients who receive hospital care under observation status do not qualify for this benefit, even if their hospital stay lasts longer than three days.
The Improving Access to Medicare Coverage Act would allow for the time patients spend in the hospital under observation status to count toward the requisite three-day hospital stay for coverage of skilled nursing care.
The legislation would:
· Amend Medicare law to count a beneficiary's time spent in the hospital on observation status" towards the three-day hospital stay requirement for skilled nursing care;
· Establish a 90-day appeal period following passage for those that have a qualifying hospital stay and have been denied skilled nursing care after January 1, 2013.
Source