Improving Access to Medicare Coverage Act of 2025
This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility (SNF) services. (Generally, individuals must have been an inpatient at a hospital for at least three days in order to qualify for SNF services. An individual's time spent under observation at a hospital for purposes of determining whether the individual should be admitted does not count towards this requirement.)
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3954 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 3954
To amend title XVIII of the Social Security Act to count a period of
receipt of outpatient observation services in a hospital toward
satisfying the 3-day inpatient hospital stay requirement for coverage
of skilled nursing facility services under Medicare, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 12, 2025
Mr. Courtney (for himself, Mr. Thompson of Pennsylvania, Ms. DelBene,
and Mr. Estes) introduced the following bill; which was referred to the
Committee on Ways and Means, and in addition to the Committee on Energy
and Commerce, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to count a period of
receipt of outpatient observation services in a hospital toward
satisfying the 3-day inpatient hospital stay requirement for coverage
of skilled nursing facility services under Medicare, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Improving Access to Medicare
Coverage Act of 2025''.
SEC. 2. COUNTING A PERIOD OF RECEIPT OF OUTPATIENT OBSERVATION SERVICES
IN A HOSPITAL TOWARD THE 3-DAY INPATIENT HOSPITAL STAY
REQUIREMENT FOR COVERAGE OF SKILLED NURSING FACILITY
SERVICES UNDER MEDICARE.
(a) In General.--Section 1861(i) of the Social Security Act (42
U.S.C. 1395x(i)) is amended by adding at the end the following: ``For
purposes of this subsection, an individual receiving outpatient
observation services shall be deemed to be an inpatient during such
period, and the date such individual ceases receiving such services
shall be deemed the hospital discharge date (unless such individual is
admitted as a hospital inpatient at the end of such period).''.
(b) Effective Date.--The amendment made by subsection (a) shall
apply to receipt of outpatient observation services beginning on or
after January 1, 2026, but applies to a period of post-hospital
extended care services that was completed before the date of the
enactment of this Act only if an administrative appeal is or has been
made with respect to such services not later than 90 days after the
date of the enactment of this Act. Notwithstanding any other provision
of law, the Secretary of Health and Human Services may implement such
amendment through an interim final regulation, program instruction, or
otherwise.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
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