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Older Americans Increasingly Left With Costly Bills After Leaving Nursing Home

By Staff | Aug 13, 2013

WASHINGTON D.C. – U.S. Senator Bob Casey (D-PA) pushed for passage of a plan that will protect Pennsylvania’s Medicare beneficiaries who may be unknowingly racking up thousands of dollars for skilled nursing care that Medicare doesn’t reimburse.

“Hospital and nursing home stays can be very stressful times time for older Americans and their families. Pennsylvania’s Medicare beneficiaries shouldn’t have to face the additional burden of thousands in medical bills that Medicare won’t reimburse,” Senator Casey said. “Older Americans living on fixed incomes have a reasonable expectation that their reimbursements will not be undermined by a bureaucratic shell game. Passing this legislation will ensure those reasonable expectations are met.”

Currently, Medicare will only cover post-acute care in a skilled nursing facility if a patient has three consecutive days of hospitalization as an inpatient, not counting the day of discharge. Because of the uptick in observation cases, patients are enduring lengthier hospital stays in observation status and may unknowingly be treated under outpatient observation status for the entirety of their hospital visit. When this happens, the beneficiaries’ SNF benefit is not activated and Medicare will not cover their stay in a nursing home causing them to face thousands of dollars in bills when they are discharged. Under the Casey-backed, bipartisan plan, the Improving Access to Medicare Coverage Act, “observation” stays will be counted toward the 3-day mandatory inpatient stay for Medicare to cover post-hospital nursing home care.