On July 30 Chairman Bill Nelson (D-FL), called a hearing before the Senate Special Committee on Aging to highlight the increasing use of hospital observation stays, and the financial implications for Medicare patients and their families. 

Medicare beneficiaries are being denied access to Medicare’s skilled nursing facility (SNF) benefit because acute care hospitals are increasingly classifying their patients as “outpatients” receiving observation services, rather than admitting them as inpatients. 

During the hearing several members of the Aging Committee renewed their support to address the impact of Medicare observation status on seniors.  Chairman Bill Nelson (D-FL), and Ranking Member Senator Susan Collins (R-ME) reiterated their support for Senator Sherrod Brown’s (D-OH) legislation, S. 569, The Improving Access to Medicare Coverage Act of 2013 -  which counts any three days a beneficiary stays in the hospital as eligible for nursing home coverage, as a simple solution to fix the observation status problem.  While, Senator Elizabeth Warren (D-MA) pointed out that some seniors might need nursing home care without going to a hospital  first.  She pointed to a 2010 pilot program in Massachusetts that found patients who were allowed to access nursing home care without the qualifying stay ended up in a hospital fewer times and cost Medicare less money over the next 60 days than other similarly situated patients who were sent to a hospital and then sent home instead.

NASL, has joined a coalition of 30 organizations - which includes the American Health Care Association (AHCA), the American Medical Association, and several beneficiary advocates, including the Center for Medicare Advocacy and AARP -  to support legislation that advocates for simplifying the three-day stay requirement, which is effectively denying some beneficiaries their post-acute care.