Coalition Applauds Congressional Champions for Protecting Access to Medicare Benefits

- Senators Kerry/Snowe and Representatives Courtney/Latham introduce legislation on observation stays –

WASHINGTON, April 14, 2011 /PRNewswire-USNewswire/ -- A multi-faceted coalition consisting of consumer groups, long term care providers, health care professionals, and others today praised U.S. Senators John Kerry (D-MA) and Olympia Snowe (R-ME) along with U.S. Representatives Joe Courtney (D-CT) and Tom Latham (R-IA) for introducing legislation that would allow access to crucial skilled nursing facility services following an observation stay in a hospital.

The Improving Access to Medicare Coverage Act of 2011(S. 818) amends the Social Security Act to include time spent under observation status in a hospital to count toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare. In order to receive coverage under Medicare Part A for skilled nursing care, patients must have been admitted to the hospital as an inpatient for three days. Often, they are instead admitted under "observation" status. The result is that they either forego their skilled nursing care due to cost or pay out-of-pocket.

"The post-acute care community thanks Senators Kerry and Snowe and Representatives Courtney and Latham for their leadership on this critical issue," stated Governor Mark Parkinson, President and CEO of the American Health Care Association (AHCA). "There is no clear-cut line between an inpatient stay and an observation stay, especially if the patient is elderly and frail."

"We look forward to working with Senators Kerry and Snowe and Representatives Courtney and Latham to secure passage of the Improving Access to Medicare Coverage Act of 2011," said Barbara Kennelly, President and CEO of the National Committee to Preserve Social Security and Medicare. "It will protect Medicare beneficiaries needing skilled nursing facility care from significant out-of-pocket costs due solely to whether they are admitted to the hospital as an inpatient or in observation status."

"On behalf of the many families who are shocked to learn, often at the time of discharge from the hospital, that they weren't 'in-patients' and now have no coverage for their nursing home care, the Center for Medicare Advocacy thanks the Senators and Congressmen for their important legislation," said Toby S. Edelman, Senior Policy Attorney with the Center for Medicare Advocacy.

"Too many seniors are caught off guard by sky-high medical bills or risk being denied coverage altogether because of the little-known distinction between an inpatient hospital stay and hospital observation," said AARP Executive Vice President Nancy LeaMond.

"We're pleased to see these members of Congress work collaboratively to ease the burden on Medicare patients and overcome the partisanship that has too often stalled progress in Washington."

The Coalition is comprised of:

AARP
Alzheimer's Association
American Health Care Association
American Medical Directors Association – Dedicated to Long Term Care Medicine
Center for Medicare Advocacy
Leading Age (formerly, the American Association of Homes and Services for the Aging)
National Committee to Preserve Social Security and Medicare

SOURCE American Health Care Association