The bill introduces to make the three-day stay exemption permanent
A bill to permanently waive the three-day hospitalization requirement for Medicare coverage of a skilled nurse stay was introduced in the House of Representatives on Tuesday, in an attempt to perpetuate the change related to the pandemic.
The bipartisan legislation, titled “Improving Access to Medicare Coverage,” was sponsored by Representatives Joe Courtney (D-CT), Suzan DelBene (D-WA), Ron Estes (R-Kansas) and Glenn Thompson (R-PA).
The American Health Care Association (AHCA) expressed support for the bill in a statement Tuesday afternoon.
“The three-day hospital stay rule means that too many seniors who need follow-up care in a skilled nursing facility are hampered by thousands of out-of-pocket expenses because they are not eligible for coverage. Medicare. For years, we have advocated to remove this confusing and devastating political obstacle, ”said Mark Parkinson, AHCA President and CEO, in a statement released Tuesday.
The initial rule change was made by the Centers for Medicare & Medicaid Services at the start of the pandemic to allow hospitals to reserve beds for critically ill patients, freeing those who may recover in an SNF.
Before the pandemic, a patient had to spend three days in hospital before Medicare covered the SNF stay that followed. Industry executives said the rule was set to ensure patients were in the best possible setting for care.
Other industry experts believe the unpopular rule sometimes leads to costly Medicare denials, sometimes to technical distinctions. Hospitals can admit elderly people for observation, a distinction that does not fit Medicare.
“The waiver of this requirement during the COVID-19 pandemic has benefited thousands of Medicare beneficiaries and demonstrated that eliminating this policy can work,” Parkinson said in the statement supporting the bill. “Now it is time for this problem to be fixed for good. We greatly appreciate that this legislation counts observation stays in the three day stay requirement, thereby helping our patients to receive the quality care they deserve without worrying about how they are going to pay for it.