Improving Access to Medicare Coverage Act of 2026
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- To President
- Became Law
Overview
This bill changes how Medicare coverage for skilled nursing facility services is determined. Specifically, it counts a period of outpatient observation services received in a hospital as equivalent to an inpatient hospital stay for three days. This change aims to improve access to Medicare benefits for individuals who receive outpatient observation services before being admitted to a skilled nursing facility. The bill takes effect on January 1, 2026, with a specific provision for appeals related to services received prior to the bill's enactment.
Key provisions
- Counts outpatient observation services as equivalent to an inpatient hospital stay for coverage of skilled nursing facility services.
- Defines the end of an outpatient observation period as the hospital discharge date.
- Applies to services received starting January 1, 2026.
Who is affected
- Medicare beneficiaries
- Skilled nursing facilities
- Hospitals
- Physicians providing outpatient observation services
Notable changes
- Expands the definition of an inpatient hospital stay for Medicare coverage purposes.
Bill text
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Sponsors
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7 on record
Primary sponsor
Cosponsors
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