HR3954119th CongressWALLET

Improving Access to Medicare Coverage Act of 2025

Sponsored By: Representative Courtney

Introduced

Summary

Counting outpatient observation toward the 3-day inpatient stay requirement. The bill would treat time a patient spends in outpatient hospital observation as inpatient days for purposes of qualifying for Medicare coverage of skilled nursing facility services and would deem the end of observation the hospital discharge date unless the patient is admitted.

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  • Families and Medicare beneficiaries: People who need post-hospital skilled nursing care would more often qualify for Medicare-covered SNF days because observation time would count toward the 3-day requirement.
  • Hospitals and clinicians: Hospitals would have a clearer rule on when an observation period becomes the hospital discharge date, which could affect admission decisions and billing practices.
  • Administration and past claims: The Secretary of Health and Human Services could implement the change by interim final rule or program instruction. The bill would also let some completed post-hospital care periods be reconsidered if an administrative appeal is filed within 90 days after enactment.

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 1 benefits, 1 costs, 0 mixed.

Observation time counts for Medicare SNF

If enacted, time you spend in hospital observation would count toward Medicare’s 3-day stay for skilled nursing facility coverage. The day you stop observation would be treated as your hospital discharge date, unless you are admitted as an inpatient then. This would apply to observation services on or after January 1, 2026. The HHS Secretary could implement this through interim final rules or program instructions.

90-day appeal window for past SNF care

If enacted, the new rule would apply to SNF care you finished before the law only if you file an administrative appeal within 90 days after enactment. Appeals already filed would count. If you miss the 90-day deadline, Medicare would not apply the new rule to those past stays, and you could owe large bills.

Sponsors & CoSponsors

Sponsor

Courtney

CT • D

Cosponsors

  • Thompson (PA)

    PA • R

    Sponsored 6/12/2025

  • DelBene

    WA • D

    Sponsored 6/12/2025

  • Estes

    KS • R

    Sponsored 6/12/2025

  • Golden (ME)

    ME • D

    Sponsored 7/16/2025

  • Brownley

    CA • D

    Sponsored 9/8/2025

  • Doggett

    TX • D

    Sponsored 9/15/2025

  • Davis (NC)

    NC • D

    Sponsored 9/30/2025

  • Moore (WI)

    WI • D

    Sponsored 10/6/2025

  • Nunn (IA)

    IA • R

    Sponsored 10/17/2025

  • Sanchez

    CA • D

    Sponsored 10/17/2025

  • Suozzi

    NY • D

    Sponsored 10/17/2025

  • Smith (NE)

    NE • R

    Sponsored 10/21/2025

  • Ross

    NC • D

    Sponsored 10/21/2025

  • Beyer

    VA • D

    Sponsored 10/31/2025

  • Pingree

    ME • D

    Sponsored 11/7/2025

  • Gottheimer

    NJ • D

    Sponsored 11/21/2025

  • Kennedy (NY)

    NY • D

    Sponsored 11/25/2025

  • Johnson (TX)

    TX • D

    Sponsored 11/25/2025

  • Schneider

    IL • D

    Sponsored 12/3/2025

  • Horsford

    NV • D

    Sponsored 12/3/2025

  • Rutherford

    FL • R

    Sponsored 12/3/2025

  • Mann

    KS • R

    Sponsored 12/10/2025

  • Thompson (CA)

    CA • D

    Sponsored 12/17/2025

  • Amo

    RI • D

    Sponsored 1/7/2026

  • Tlaib

    MI • D

    Sponsored 2/3/2026

  • Scanlon

    PA • D

    Sponsored 2/3/2026

  • Lynch

    MA • D

    Sponsored 2/10/2026

  • Del. Norton, Eleanor Holmes [D-DC-At Large]

    DC • D

    Sponsored 2/17/2026

  • Meuser

    PA • R

    Sponsored 3/4/2026

  • Raskin

    MD • D

    Sponsored 3/4/2026

Roll Call Votes

No roll call votes available for this bill.

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