government

Senate bill would alter Medicare nursing home mandate

NEWS IN BRIEF — Posted March 4, 2013

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Medicare patients would gain skilled nursing facility coverage after three days in the hospital regardless of admission status under legislation proposed in the Senate.

Medicare law requires beneficiaries to stay at least three days as a hospital inpatient before the entitlement program will cover postacute care in a nursing facility. Hospital care while in observation, technically an outpatient service, does not count toward the minimum for skilled nursing facility coverage. Patients without at least three inpatient days must pay for postacute facility care out of pocket.

Many patients are unaware of the policy, said Sen. Charles Schumer (D, N.Y.), who spoke on Feb. 20 about his legislation to address the problem. The bill would change Medicare law so observation stays count toward the three-day requirement.

“A flawed Medicare law is to blame, and I have a plan to change that, so hundreds of thousands of seniors … are not hit with huge rehabilitation bills after a lengthy hospital visit,” he said.

The American Medical Association has supported changing the coverage requirement to minimize financial exposure for patients. An increase in audits targeting admissions has exacerbated the problem, with hospitals sometimes changing patients’ status retroactively in order to avoid payment denials.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn