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.

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 4641 Introduced in Senate (IS)]

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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.
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