A bill to permanently waive the three-day inpatient hospital stay requirement for Medicare coverage of a skilled nursing stay was introduced in the House of Representatives on Tuesday, an attempt to make the pandemic-related change stick around long-term.
The bipartisan legislation, titled the “Improving Access to Medicare Coverage Act,” was sponsored by Reps. 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 causes too many seniors who need follow-up care in a skilled nursing facility to be shackled with out-of-pocket costs in the thousands because they do not qualify for Medicare coverage. For years we have advocated to eliminate this confusing and devastating policy barrier,” Mark Parkinson, president and chief executive of AHCA, said in a statement released Tuesday.
The initial rule change was made by the Centers for Medicare & Medicaid Services at the beginning of the pandemic in order to allow hospitals to reserve beds for severely ill patients, discharging those who could recover at a SNF.
Prior to the pandemic, a patient needed to have a three-day inpatient hospital stay before Medicare would cover the SNF stay that followed. Industry leaders said the rule was established to make sure patients were in the best possible setting for care.
Other industry specialists believe the unpopular rule sometimes leads to expensive Medicare denials, sometimes over technical distinctions. Hospitals can admit seniors for observation, a distinction that doesn’t fit in the Medicare mold.
“The waiver of this requirement during the COVID-19 pandemic public health emergency 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 this issue was fixed permanently. We greatly appreciate that this legislation will count observation stays toward the three-day stay requirement, ultimately helping our patients receive the quality care they deserve without worrying about how they’re going to pay for it.”
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