[Congressional Record (Bound Edition), Volume 156 (2010), Part 10]
[Extensions of Remarks]
[Page 14778]
[From the U.S. Government Publishing Office, www.gpo.gov]




     INTRODUCTION OF THE IMPROVING ACCESS TO MEDICARE COVERAGE ACT

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                           HON. JOE COURTNEY

                             of connecticut

                    in the house of representatives

                        Thursday, July 29, 2010

  Mr. COURTNEY. Madam Speaker, today on the eve of Medicare's 45th 
anniversary, I rise to recognize the tireless work and fierce vigilance 
of an organization that has prioritized the care needs of Medicare 
beneficiaries, the Center for Medicare Advocacy, as well as bring to 
light a coverage issue that the agency has been worked on for years: 
lengthy hospital observation stays.
  Earlier this summer, I had discussions with leaders of the Center for 
Medicare Advocacy about lengthy hospital observation stays which has 
inhibited care for Medicare beneficiaries. Excessive time on hospital 
observation status has been shown to create two potential problems for 
Medicare beneficiaries. First, prescription drugs administered in the 
hospital during an observation stay are not included in the inpatient 
deductible cap, which can easily become unaffordable for patients and 
their families if the medications are not included in the beneficiary's 
Part D formulary. Secondly, time spent on observation status in a 
hospital is not counted towards the three-day inpatient hospital stay 
required for the beneficiary to receive skilled nursing care. Both 
potential consequences create financial and care burdens for Medicare 
beneficiaries.
  Earlier in the month, I met with the Renshaw family from my district 
that had been negatively affected by a lengthy hospital observation 
status. After falling and breaking his hip, Mr. Renshaw, an elderly 
Medicare beneficiary, was taken to a local hospital treatment where he 
was subsequently put on observation status. He remained in the hospital 
for four days. After he was released, Mr. Renshaw required skilled 
nursing care for his rehabilitation. However, because Mr. Renshaw was 
placed on observation status instead of admitted officially as an 
inpatient, his time in the hospital did not count towards the Medicare 
three-day hospital stay required for skilled nursing care. His family 
was forced to write a check for nearly $10,000 in order to get him the 
care that he needed because Medicare would not cover this benefit.
  In response to the Center for Medicare Advocacy's vigilance on this 
issue and the experiences shared with me by the Renshaw family, I am 
introducing the Improving Access to Medicare Coverage Act. My 
legislation will fix this unfair component of Medicare law that 
arbitrarily differentiates between patients on inpatient versus 
observation status with obtaining necessary skilled care. The Improving 
Access to Medicare Coverage Act will count a beneficiary's time on 
observation towards the three-day hospital stay requirement for skilled 
nursing care. And while my legislation does not address the challenges 
associated with unaffordable out-of-pocket prescription drug and other 
costs associated with lengthy hospital observation stays, I look 
forward to working with the Center for Medicare Advocacy on finding a 
long-term solution to this urgent problem.

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