Renacci Introduces Bipartisan Bill To Enhance Access To Quality Care For Seniors11/19/13
Rep. Jim Renacci (OH-16) today introduced H.R. 3531, the Creating Access to Rehabilitation for Every Senior (CARES) Act. This bipartisan bill will reduce barriers to health care services for our nation’s seniors by eliminating the three-day inpatient hospital stay requirement for Medicare beneficiaries who are in need of skilled nursing facility (SNF) services. Eliminating the three-day stay requirement is supported by both hospitals and nursing homes throughout the country.
“The Creating Access to Rehabilitation for Every Senior (CARES) Act will enhance access to quality care for our nation’s seniors by protecting the doctor-patient relationship and removing Washington red tape as a barrier to their health care,” said Rep. Jim Renacci. “Beneficiaries in need of skilled nursing care are typically the frailest and oldest of the Medicare population, and they should not be shut out of these critical rehabilitation services due to Washington over-regulation. As a former operator and manager of long-term care facilities in Northeast Ohio, I remain committed to finding bipartisan solutions that will allow Ohio seniors to receive the treatment they need at the time they need it – without Washington standing in the way.”
Peter Van Runkle, Executive Director of the Ohio Health Care Association, added, “Medicare covers short-term skilled nursing care and rehabilitation for seniors, but discriminates against seniors who need care but didn’t spend three days as a hospital inpatient. We applaud Congressman Renacci’s courageous effort to eliminate discrimination and cover all seniors who need these important services.”
James Griffiths, CEO of JAG Healthcare in Rocky River, OH, added, "There is no question that the future of health care will be dependent on efficiency and quality. It makes perfect sense to eliminate the three-day qualifying hospital stays for Medicare recipients because it will enable skilled nursing facilities and other providers along the continuum to provide services without the clumsy and in some cases unnecessary acute care stop. As our population ages, it makes no sense to require a costly and unnecessary acute care stay when beneficiaries need care."
• Rep. Marcia Fudge (D-OH), Rep. Tom Price (R-GA), Rep. Daniel Webster (R-FL), Rep. Mike Kelly (R-PA), Rep. Steve Stivers (R-OH), Rep. John Carney (D-DE), Rep. Ron Barber (D-AZ), Rep. Larry Bucshon (R-LA), and Rep. Derek Kilmer (D-WA) are all lead co-sponsors of the bill.
• Under current Medicare payment policy, in order for Medicare to cover skilled nursing facility (SNF) services, the beneficiary must have an inpatient hospital stay lasting at least three days. Many beneficiaries are often unaware of their observation or inpatient status since they are likely receiving the same services in the same hospital bed. Unlike other post-acute care services, Medicare only requires an inpatient hospital stay for SNFs causing further confusion for beneficiaries.
• A July 2013 memorandum issued by the Office of the Inspector General (OIG) reported that beneficiaries had 617,702 hospital stays that lasted at least three nights, but did not include three inpatient nights; these beneficiaries did not qualify for SNF services under Medicare.
• In September 2013, the Commission on Long-Term Care called for the enactment of legislation to eliminate the requirement of a prior three-day inpatient stay in a SNF.
• Most Medicare Advantage plans have already eliminated the inpatient requirement and its time traditional Medicare move in that direction as it will not only benefit the patient, but also prove to be more cost effective.
• A recent study from Brown University comparing 14 Medicare Advantage and 14 matched control plans found no evidence that eliminating the requirement increased the probability of a SNF admission, the number of SNF admissions, or the length of stay in SNF. The findings suggest that Medicare Advantage plans may recognize the important cost-savings by eliminating this policy and raise questions about the value of retaining the qualifying stay requirement for traditional Medicare enrollees.