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Improving Access to Medicare Coverage Act of 2026 This 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.)
Plain-English rewrite of the Congressional Research Service summary published on Congress.gov. Cached and reviewed.
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[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [S. 4641 Introduced in Senate (IS)] <DOC> 119th CONGRESS 2d Session S. 4641 To amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare. _______________________________________________________________________ IN THE SENATE OF THE UNITED STATES May 21, 2026 Ms. Collins (for herself, Mr. Welch, and Mrs. Capito) introduced the following bill; which was read twice and referred to the Committee on Finance _______________________________________________________________________ A BILL To amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the ``Improving Access to Medicare Coverage Act of 2026''. SEC. 2. COUNTING A PERIOD OF RECEIPT OF OUTPATIENT OBSERVATION SERVICES IN A HOSPITAL TOWARD THE 3-DAY INPATIENT HOSPITAL REQUIREMENT FOR COVERAGE OF SKILLED NURSING FACILITY SERVICES UNDER MEDICARE. (a) In General.--Section 1861(i) of the Social Security Act (42 U.S.C. 1395x(i)) is amended by adding at the end the following: ``For purposes of this subsection, an individual receiving outpatient observation services shall be deemed to be an inpatient during such period, and the date such individual ceases receiving such services shall be deemed the hospital discharge date (unless such individual is admitted as a hospital inpatient at the end of such period).''. (b) Effective Date.--The amendment made by subsection (a) shall apply to receipt of outpatient observation services beginning on or after January 1, 2026, but applies to a period of post-hospital extended care services that was completed before the date of the enactment of this Act only if an administrative appeal is or has been made with respect to such services not later than 90 days after the date of the enactment of this Act. Notwithstanding any other provision of law, the Secretary of Health and Human Services may implement such amendment through an interim final regulation, program instruction, or otherwise. <all>
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