Improving Access To Medicare Dollars

Yesterday in both the House and the Senate, a new bill was introduced that may help to address the issue of seniors being able to qualify for Medicare coverage when being admitted under “Observation” status.

Currently, a senior must be classified as an “inpatient” for three days (not counting the day of discharge) before Medicare will pay for charges incurred upon transfer to a Skilled Nursing Facility.

Many times, the senior and/or family members are not aware of the patient’s classification in an acute care hospital because the patient may receive the SAME medically necessary treatment, nursing care, medications, treatments, diagnostic testing and therapies as any other hospital patient and they may remain in the hospital just like any other patient but be considered on “observation”.

Of course, this is ridiculous and has caused many families to pay unnecessary monies .

A bill is entitled “Improving Access to Medicare Coverage Act”  was introduced by Congressmen Courtney and Latham (H.R. 1179) and by Senator Brown (S. 569).

If passed, the bill would allow “observation stays” to be counted towards the three day mandatory inpatient stay that is required in order for Medicare to cover Skilled Nursing Facility charges upon transfer from a hospital.

The National Association of Professional Geriatric Care Managers (NAPGCM) has been active in support of this bill and will be sending us, as care managers, instructions on how to ask your member of Congress to co-sponsor the bill.  I will pass that information along to you when I receive it.


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