December 10, 2015
To the Health and Long-Term Care Committee, State Government Affairs & Community Relations Council Directors, & other Interested Parties:
For the past two years, Jewish federations and partner agencies have focused on ensuring that Medicare Beneficiaries have access to skilled nursing benefits. This access has been threatened because of a new classification called Observation Stays.
The Ask: Please reach out to your member of Congress to co-sponsor The Improving Access to Medicare Coverage Act of 2015 (H.R. 1571) (S. 843). As you can see from the list that is linked to below, some members who supported the legislation in the last Congress have not yet signed onto this year’s bill. We hope you will work with us to ensure that your legislators sign on as co-sponsors so that Congress can “right this wrong” for scores of older Americans and their families.
The Rationale: Unfortunately, Medicare recipients are being denied reimbursement because of a way that hospitals are classifying patients under an “Observation Stay” vs. “Admission” status. This category switch has protected hospitals against reimbursement penalties for readmission, but it has caused major out-of-pocket costs for patients in need of post-acute care. It is time for Congress to act and count days spent in Observation toward Medicare’s three-day prior inpatient stay. This will allow the patient to gain access to the skilled nursing benefit, and will also ensure that Jewish aging facilities are paid for these services.
Please review the following important documents on this issue:
1) A briefer on the Improving Access to Medicare Coverage Act
2) Template Letters for your Representatives and Senators
3) A list of co-sponsors in the House and Senate, who supported this initiative in the past, but have not yet renewed their co-sponsorship.
4) Media outlets such as The Wall Street Journal are focusing on this issue, which was highlighted on their front page last week, given the snowball effect it is having on long-term care. Here is a recent story in McKnight’s on the Observation Stay issue: Analysis: Observation stays skyrocket, jeopardize SNF admissions
As the Congressional session comes to a close, please make every effort to reach out to your member of Congress to secure this support and ensure that this legislation becomes a reality so that no older adult will be denied access to these vital skilled nursing benefits. On a related note, if you would like to join JFNA’s Healthcare Leadership List and receive the latest updates on these issues, please email firstname.lastname@example.org.
William C. Daroff
Senior Vice President for Public Policy &
Director of the Washington Office