Improving Access to Medicare Coverage Act of 2023

Improving Access to Medicare Coverage Act of 2023

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.)

Bill 118 HR 5138, also known as the Improving Access to Medicare Coverage Act of 2023, aims to address issues related to Medicare coverage for individuals who are eligible for both Medicare and Medicaid, also known as dual-eligible individuals. The bill seeks to streamline the process for these individuals to enroll in Medicare Part B, which covers outpatient services such as doctor visits and preventive care.

One of the key provisions of the bill is the establishment of a new enrollment period for dual-eligible individuals to sign up for Medicare Part B. Currently, these individuals are required to enroll in Part B during specific enrollment periods, which can lead to gaps in coverage and delays in accessing necessary medical services. The bill aims to simplify this process by allowing dual-eligible individuals to enroll in Part B at any time, ensuring that they have continuous access to essential healthcare services.

Additionally, the bill includes provisions to improve coordination between Medicare and Medicaid for dual-eligible individuals, ensuring that they receive the full range of benefits to which they are entitled. This includes measures to streamline the process for these individuals to access prescription drug coverage and other essential services. Overall, the Improving Access to Medicare Coverage Act of 2023 seeks to address the unique challenges faced by dual-eligible individuals in accessing Medicare coverage and ensure that they receive the care they need in a timely and efficient manner. By simplifying the enrollment process and improving coordination between Medicare and Medicaid, the bill aims to improve access to healthcare services for this vulnerable population.