Bill Would Close Loophole in Medicare SNF Coverage

Senator Chuck Schumer (D-N.Y.) has introduced legislation to expand Medicare coverage of rehabilitation treatment in skilled nursing facilities.


Senator Chuck Schumer (D-N.Y.) has introduced legislation to expand Medicare coverage of rehabilitation treatment in skilled nursing facilities.

Under current rules, Medicare covers post-acute care in a skilled nursing facility if a patient had at least three consecutive days of hospitalization as an inpatient. However, patients admitted for ‘observation’ are not considered to have been formally admitted to the hospital. Because these patients don’t meet the three-day hospital inpatient stay threshold, Medicare doesn’t pay for the SNF treatment.

Under Schumer’s legislation, titled, “The Improving Access to Medicare Coverage Act,” observation days would be counted toward the three-day mandatory inpatient stay, thus covering rehabilitation in a skilled nursing facility.

The Alliance for Quality Nursing Home Care, whose members provide skilled nursing care in about 1,200 facilities, supports the bill, which soon will be available on the congressional Web site.

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