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117TH CONGRESS
1ST SESSION H. R. 3650
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 stay requirement for coverage of skilled nursing
facility services under Medicare, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JUNE 1, 2021
Mr. COURTNEY (for himself, Mr. THOMPSON of Pennsylvania, Mr. ESTES, and
Ms. DELBENE) introduced the following bill; which was referred to the
Committee on Ways and Means, and in addition to the Committee on En-
ergy 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
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 hos-
pital stay requirement for coverage of skilled nursing
facility services under Medicare, and for other purposes.
Be it enacted by the Senate and House of Representa-
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tives of the United States of America in Congress assembled,
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SECTION 1. SHORT TITLE.
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This Act may be cited as the ‘‘Improving Access to
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Medicare Coverage Act of 2021’’.
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•HR 3650 IH
SEC. 2. COUNTING A PERIOD OF RECEIPT OF OUTPATIENT
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OBSERVATION SERVICES IN A HOSPITAL TO-
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WARD THE 3-DAY INPATIENT HOSPITAL STAY
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REQUIREMENT FOR COVERAGE OF SKILLED
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NURSING FACILITY SERVICES UNDER MEDI-
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CARE.
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(a) IN GENERAL.—Section 1861(i) of the Social Se-
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curity Act (42 U.S.C. 1395x(i)) is amended by adding at
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the end the following: ‘‘For purposes of this subsection,
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an individual receiving outpatient observation services
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shall be deemed to be an inpatient during such period,
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and the date such individual ceases receiving such services
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shall be deemed the hospital discharge date (unless such
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individual is admitted as a hospital inpatient at the end
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of such period).’’.
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(b) EFFECTIVE DATE.—The amendment made by
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subsection (a) shall apply to receipt of outpatient observa-
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tion services beginning on or after January 1, 2021, but
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applies to a period of post-hospital extended care services
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that was completed before the date of the enactment of
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this Act only if an administrative appeal is or has been
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made with respect to such services not later than 90 days
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after the date of the enactment of this Act. Notwith-
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standing any other provision of law, the Secretary of
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Health and Human Services may implement such amend-
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•HR 3650 IH
ment through an interim final regulation, program in-
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struction, or otherwise.
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