Medicare Coverage Improvement Bill
Official: Improving Access to Medicare Coverage Act of 2025
This bill changes Medicare rules so that time spent in outpatient observation at a hospital counts toward the required three-day inpatient stay for nursing home coverage. This is important because it helps more patients access necessary care after hospital visits.
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.)
1. This bill allows outpatient observation time in hospitals to count as part of the required hospital stay for Medicare. 2. Patients receiving outpatient observation services will be considered inpatients for the purpose of Medicare coverage. 3. The change helps patients qualify for skilled nursing facility services more easily. 4. The new rule will start applying to services received on or after January 1, 2026. 5. Patients can appeal for past services if they act within 90 days after the bill becomes law.
Patients who receive outpatient observation services in hospitals and need skilled nursing care afterward.