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Medicare: Counting Hospital Observation Time Towards 3-Day Inpatient Stay Requirement.

This bill improves access to Skilled Nursing Facility (SNF) services under Medicare. The time a patient spends receiving outpatient observation services in a hospital will now count toward the mandatory 3-day inpatient hospital stay requirement for SNF coverage. This change ensures that patients are not denied post-hospital care coverage simply because they were classified as 'observation' rather than formally admitted as 'inpatient' for the full three days, reducing financial barriers for necessary follow-up care.
Key points
Medicare Rule Change: Outpatient observation services in a hospital will be deemed equivalent to an inpatient stay for the purpose of meeting the 3-day requirement for SNF coverage.
Improved SNF Access: Meeting the 3-day inpatient stay requirement is crucial for Medicare coverage of Skilled Nursing Facility services; this rule change simplifies qualification.
Effective Date: The amendment applies to observation services received on or after January 1, 2024, with a provision allowing administrative appeals for services completed before the enactment date, if filed within 90 days.
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Additional Information
Improving Access to Medicare Coverage Act of 2024
Print number: S 4137
Sponsor: Sen. Brown, Sherrod [D-OH]
Process start date: 2024-04-17