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Medicare Access Improvement: Counting Hospital Observation Stays

New rules will make it easier for Medicare beneficiaries to access skilled nursing facility care. Time spent under hospital observation will now count towards the required three-day inpatient stay, which is crucial for benefit eligibility. This change could help many individuals cover the costs of post-hospital care.
Key points
Time spent receiving outpatient observation services in a hospital will now count towards the three-day inpatient hospital stay requirement for Medicare coverage of skilled nursing facility services.
This change applies to observation services received on or after January 1, 2024. In some cases, it may also apply to services completed before the act's enactment if an administrative appeal was filed.
The aim is to improve access to Medicare benefits for individuals needing post-hospital care, even if they were not formally admitted as inpatients.
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Additional Information
Improving Access to Medicare Coverage Act of 2023
Print number: HR 5138
Sponsor: Rep. Courtney, Joe [D-CT-2]
Process start date: 2023-08-04