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AHCA Pushing Bill to Protect Senior Citizens' Full Access to Skilled Nursing in Medicare

Improving Access to Medicare Coverage Act of 2011 presented by Senators John Kerry (D-MA), Olympia Snowe (R-ME) and Representatives Joe Courtney (D-CT), Tom Latham (R-IA)

Gov. Mark Parkinson, President, AHCAApril 26, 2011 - The American Health Care Association (AHCA) on April 14 issued a news release applauding the introduction of “bipartisan” legislation in both Houses of Congress to remedy for senior citizens the “complex and confusing process resulting from observation status during a hospital stay.”

“There is a growing trend harming seniors who need critical skilled nursing care following a hospital stay that often leaves them in a no-mans land,” stated Governor Mark Parkinson, President and CEO of AHCA.

Introduced by Senators John Kerry (D-MA) and Olympia Snowe (R-ME) along with Representatives Joe Courtney (D-CT) and Tom Latham (R-IA), the Improving Access to Medicare Coverage Act of 2011 would rectify a confusing status that leaves seniors in a limbo land of healthcare delivery. The bill ensures that 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.


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Often patients are kept much longer than the prescribed limit for observation stays and are not informed of their admission status. In fact, says the AHCA, from 2007-2009 the number of patients spending four or more days under observation status doubled.

"Patients who need to enter a skilled nursing facility following an observation stay face the possibility that their care in the facility will not be covered by Medicare Part A because of the lack of hospital classification as an inpatient," says the AHCA news release.

"This can result in patient confusion and the possibility of not receiving appropriate and necessary skilled nursing care. In some instances, patients arrive at a nursing facility, and because Medicare will not cover the benefit they are forced to pay out-of-pocket."

“The post-acute care profession is eager to work with our Congressional champions, hospitals, physicians and CMS to ensure that beneficiaries are not deprived of necessary and appropriate Medicare-covered post-acute care because of lengthy observation stays,” Parkinson concluded.

 “Sens. Kerry and Snowe and Reps. Courtney and Latham recognize this problem and how deep it runs, and we applaud their efforts ensuring that we can not ask the elderly and frail to pay with his or her health.”

“When senior citizens get sick they need to know that they’ll get the care they need. The last thing they should have to worry about is a billing technicality that could saddle them with outrageous out of pocket costs,” Senator Kerry said.

“This bill will eliminate an unnecessary financial hardship on Medicare beneficiaries that can stand in the way of the skilled nursing care they need. I look forward to working with Senator Snowe and Congressman Courtney to bring some peace of mind to patients and their families.”

“When patients should be focusing on their recovery, far too many are caught off-guard by this ambiguous policy,” said Senator Snowe.

“This bipartisan legislation provides much needed clarity and will ensure that patients receive the full coverage they deserve.”

“This commonsense change will ensure that seniors no longer face thousands of dollars in bills for skilled care because of an arbitrary federal policy,” said Congressman Courtney. “There are no two ways about it: three days in the hospital are three days in the hospital. Anyone who meets that threshold should receive the same benefit from Medicare.”

As the nation’s largest association of long term and post-acute care providers, the American Health Care Association (AHCA) says it “advocates for quality care and services for frail, elderly and disabled Americans. Compassionate and caring employees provide essential care to one million individuals in our 11,000 not-for-profit and proprietary member facilities.”


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