Improving Access to Medicare Coverage Act of 2026

Susan M. Collins

Republican · ME · Senator

Source: Congress.gov · FEC

• Peter Welch (D-VT)Original· 2026-05-21
• Shelley Moore Capito (R-WV)Original· 2026-05-21

Read twice and referred to the Committee on Finance.

2026-05-21

Source: Congress.gov

Medicare currently requires seniors to spend at least 3 days as an inpatient in a hospital before they can qualify for coverage of skilled nursing facility care, but this bill would allow time spent receiving observation services in a hospital outpatient department to count toward that 3-day requirement. This change would help Medicare beneficiaries who receive extended observation care qualify for nursing home coverage without having to be formally admitted as inpatients, potentially reducing out-of-pocket costs for seniors needing post-hospital care.

AI-assisted summary generated from the official bill metadata (title, subjects, actions) sourced from Congress.gov. Cached and reviewed. Always verify against the official text linked below.

[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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