Congress makes another attempt to eliminate three-midnight rule barriers to SNF coverage

Mar 15, 2019
The Bottom Line

This March, Congress will re-introduce legislation with bipartisan support to allow Medicare beneficiaries that are hospitalized in observation to qualify for SNF coverage following their hospital stay. Currently, under the three-midnight rule, beneficiaries mThis March, Congress will re-introduce legislation with bipartisan support to allow Medicare beneficiaries that are hospitalized in observation to qualify for SNF coverage following their hospital stay. Currently, under the three-midnight rule, beneficiaries must have been categorized as being an inpatient in a hospital for three midnights in order to qualify for a Medicare Part A SNF stay.

SNFs have become all too familiar with a costly scenario: A patient leaves the hospital after a few days and moves on to a SNF, only to learn that Medicare won’t cover his or her SNF care as expected. The beneficiary is frustrated, and the SNF often inappropriately bills Medicare.

The Improving Access to Medicare Coverage Act (H.R. 1682/S. 753) advocates to remove this barrier by ensuring “that time spent under ‘observation status’ in a hospital counts toward satisfying the three-day inpatient hospital requirement for coverage of skilled nursing care services under Medicare,” reports the American Health Care Association.
 

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