Congressman Joe Courtney (D, CT) and a bipartisan group of colleagues reintroduce Improving Access to Medicare Coverage Act of 2023, H.R. 5138, a bill to ensure that patients qualify for post-hospital Medicare-covered care in a skilled nursing facility (SNF) when they are in a hospital for three or more consecutive days. See Press Release and H.R. 5138.
Under current Medicare law, only time in the hospital that is classified as “inpatient” counts in the calculation of days. Many patients are called “outpatients in observation,” however, even though their “outpatient” care may be indistinguishable from the care provided to “inpatients.” The result of observation status is that patients are forced either to pay for SNF care out-of-pocket, spending thousands of dollars, or more, for a SNF stay, or to forego post-hospital care that they need. As Mr. Courtney says in support of the legislation, “‘People deserve better. . . . three days is three days.’”
During the COVID-19 pandemic, the federal government waived the three-day inpatient requirement. With the end of the public health emergency on May 20, many patients are now, once again, facing the observation status barrier to medically necessary post-hospital care that is covered by Medicare.
Congressman Courtney’s Press Release quotes support from Center for Medicare Advocacy Executive Director Judy Stein, who thanks the Congressman for “his tenacious commitment to correcting this longstanding problem and to ensuring that all Medicare patients receive the Medicare-covered care they need.”
An ad hoc coalition of more than 30 national organizations support the legislation, including health care professionals and advocacy organizations: AARP, the American Medical Association, the Society for Hospital Medicine, the American Geriatrics Society, the Center for Medicare Advocacy, and that National Consumer Voice for Quality Long-Term Care. See coalition’s supporting document. The Center for Medicare Advocacy staff initially formed, and remain active in, the coalition.
August 10, 2023 – T. Edelman