Improving Access to Medicare Coverage Act of 2025
Improving Access to Medicare Coverage Act of 2025
Plain Language Summary
# Improving Access to Medicare Coverage Act of 2025 - Summary **What the Bill Would Do:** This bill would change Medicare rules to make it easier for seniors to qualify for skilled nursing facility (SNF) care—the type of specialized care patients receive after hospitalization. Currently, Medicare requires patients to spend at least three days as a hospital inpatient to qualify for SNF coverage. The bill would count time spent under "observation" (when doctors are evaluating whether to officially admit you) toward that three-day requirement. In practice, this means more seniors could qualify for nursing facility coverage without needing a formal three-day hospital stay. **Who It Affects and Why It Matters:** This affects Medicare beneficiaries (seniors age 65+), hospitals, and nursing facilities.
Many patients spend time under hospital observation without being officially "admitted," and currently those hours don't count toward the three-day threshold. This gap can leave patients responsible for their own nursing care costs. The bill aims to eliminate this loophole and ensure patients aren't penalized financially when hospitals use observation status instead of formal admission. **Current Status:** The bill was introduced by Rep. Joe Courtney (D-CT) and is currently in committee, meaning it hasn't yet been voted on by the full House.
CRS Official Summary
Improving Access to Medicare Coverage Act of 2025This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility (SNF) services. (Generally, individuals must have been an inpatient at a hospital for at least three days in order to qualify for SNF services. An individual's time spent under observation at a hospital for purposes of determining whether the individual should be admitted does not count towards this requirement.)
Latest Action
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.