NAPGCM Public Policy E-Newsletter: Observation Status Grassroots Alert

Observation Status Grassroots Alert
Released to NAPGCM Membership on June 30, 2014

Observation Status

Observation status refers to the classification of a patient in an acute care hospital as an outpatient, even though, just like an inpatient, the person is placed in a bed in the hospital, stays overnight, and receives medically necessary nursing, medical care, diagnostic tests, treatments, therapy, prescription and over-the-counter medications, and food. However, classification as an outpatient may make a patient ineligible for Medicare coverage of subsequent skilled nursing facility (SNF) care because the Medicare statute requires three days of inpatient status (not counting the day of discharge) as a precondition to Medicare coverage of care in a SNF. Over the past few years, we have heard from NAPGCM members regarding this issue and how it impacts clients and we have advocated for solutions at the federal level.

113th Congress Legislation

NAPGCM supports changes to observation status that are embodied in bipartisan and bicameral legislation, the "Improving Access to Medicare Coverage Act, H.R. 1179/S. 569," would address this issue by allowing observation stays to be counted toward the three day mandatory inpatient stay for Medicare coverage of SNF services. We sent a support letter to both the House and Senate sponsors in February 2013 (click here). We are working as part of a larger coalition to resolve this issue legislatively this year (click here).

The bill continues to gain support. The House measure has 152 cosponsors while the Senate version has 25 cosponsors. Increasing the number of cosponsors is critical to resolving the issue this year.

How To Take Action:

We are committed to ending this practice and we encourage NAPGCM members to contact your Member of Congress as soon as possible in support of this legislation.

  1. To participate, reach your Members of Congress via phone or email.

CALL: Capitol Switchboard (202-224-3121) can connect you to your Senator or Representative's offices. Ask the Switchboard to connect you to your specific office.

After identifying yourself as a constituent, ask your Member of Congress to cosponsor the House or Senate bill

EMAIL: Go to each Member's website and submit your comments there.

Find your Member of Congress here or

  1. Use social media to weigh in with lawmakers. Use your Twitter messages and/or encourage your Facebook followers to weigh in this week with the messages above.