Fairness for Beneficiaries Act of 2013 eases access to SNF Medicare benefits
Washington, DC – The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) today commended Rep. Jim McDermott (D-WA) for introducing the Fairness for Beneficiaries Act of 2013. The legislation repeals the three-day inpatient stay Medicare requirement that beneficiaries must satisfy before they are eligible for skilled nursing care center benefits.
“This bill addresses a long-standing issue facing the nation’s seniors and individuals with disabilities,” said Mark Parkinson, President and CEO of AHCA/NCAL. “By eliminating the red tape of three-day stay requirements, we are protecting beneficiaries’ access to skilled nursing care services.”
The Fairness for Beneficiaries Act of 2013 repeals the three-day stay requirement and also includes protections against fraud, waste and abuse. It retains the current requirement that all skilled nursing care must be deemed medically necessary in order for patients to access the Medicare Part A benefit. The bill also requires the Health and Human Services Secretary to develop a uniform set of criteria to support medical necessity determinations.
McDermott specifically cited the work of the Commission on Long Term Care, who recommended the three-day stay be eliminated, as a motivator to put the bill into play in Congress.
“The Long Term Care Commission created specific recommendations in an effort to solve some of the challenges that face long term and post-acute care profession,” said Neil Pruitt, Jr., LTC Commissioner and Chair of AHCA. “It is rewarding and encouraging to see leaders like Rep. McDermott put those recommendations into action.”
“I am pleased to see that the Commission’s report is gaining traction,” said Stephen Guillard, LTC Commissioner and former EVP/COO at HCR ManorCare, a long term and post-acute care provider. “It is my hope that the profession continues to see efforts by our nation’s leaders to remove red tape and ease access to important long term care services.”
AHCA/NCAL supports eliminating the three-day stay requirement and solving the related issue of observation stays. The association continues to support Reps. Joe Courtney (D-CT) and Tom Latham (R-IA), along with Sen. Sherrod Brown (D-OH) in the legislation they introduced, The Improving Access to Medicare Coverage Act of 2013, which seeks to count all hospital days spent in observation towards the three-day stay requirement. For more information about observation stays and the three-day stay requirement, visit the AHCA/NCAL website.
The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) represent more than 12,000 non-profit and proprietary skilled nursing centers, assisted living communities, sub-acute centers and homes for individuals with intellectual and development disabilities. By delivering solutions for quality care, AHCA/NCAL aims to improve the lives of the millions of frail, elderly and individuals with disabilities who receive long term or post-acute care in our member facilities each day. For more information, please visit www.ahca.org or www.ncal.org.