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Life Health > Health Insurance > Medicare Planning

'Common sense' bill would change Medicare requirement

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A bill to cover seniors’ need for skilled nursing care following an observational stay at a hospital is making its way through Congress. The bipartisan legislation, entitled the Improving Access to Medicare Coverage Act of 2011, is being praised by provider groups, such as the American Health Care Association.

The bill alters the Social Security Act to include a senior’s time spent under observation status at a hospital in the three-day stay requirement used by Medicare to qualify patients for skilled nursing care once they return home. Under current rules, a Medicare beneficiary must be classified as a hospital inpatient, a status that doctors and hospitals are increasingly hesitant to bestow for fear that their admissions will be audited by the Centers for Medicare & Medicaid Services.

Regarding the proposed rule change, Rep. Joe Courtney, D-CT, one of the bill’s sponsors, said, “This common sense change will ensure that seniors no longer face thousands of dollars in bills for skilled care because of an arbitrary federal policy. There are no two ways about it: Three days in the hospital are three days in the hospital. Anyone who meets that threshold should receive the same benefit from Medicare.”


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