U.S. Senators Sherrod Brown (D-OH), Susan Collins (R-ME) and Sheldon Whitehouse (D-RI) on April 24 announced the introduction of the Improving Access to Medicare Coverage Act. This bill would: 1) allow for the time patients spend in the hospital under “observation status” to count toward the requisite three-day hospital stay for coverage of skilled nursing care; and 2) establish a 90-day appeal period for those that have a qualifying hospital stay and have been denied skilled nursing care after January 1, 2024.

Under current Medicare policy, a beneficiary must have an “inpatient” hospital stay of at least three days in order for Medicare to cover post-hospitalization skilled nursing care. Patients that receive hospital care under “observation status” or an “observation stay” do not qualify for this benefit, even if their hospital stay lasts longer than three days.

The Senate version of the Improving Access to Medicare Coverage Act is a companion bill to H.R. 5138 of the same name that was introduced by Rep. Joe Courtney (D-CT) on August 4, 2023. LeadingAge has endorsed both the House and Senate bills and will continue working with our coalition partners to advance this legislation.