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Vermont ACO Tests 1-Night Hospital-Stay Waiver

Dana Halvorson

According to an August 22, 2018, article from McKnight’s, “OneCare Vermont — a statewide ACO coordinating care for more than 112,000 beneficiaries — just launched a new pilot program with three local skilled nursing facilities. The three SNFs will now be able to accept Vermont Medicare patients after just one day in the hospital, according to the Sentinel. Typically, under Medicare rules, patients need to be at a hospital for at least three consecutive days before Medicare covers their treatment at a SNF. The OneCare Vermont ACO is granting two local hospitals and its SNF partners a waiver to drop the requirement to one day under a new pilot program. The change will affect some 5,000 patients.” The full McKnight’s article can be found here.

AHCA/NCAL supports eliminating the three-day stay requirement and solving the related issue of observation stays. AHCA/NCAL also continues to advocate for the Improving Access to Medicare Coverage Act of 2017 (S. 568/H.R. 1421) that was introduced on March 8, 2017, by Congressmen Joe Courtney (D-CT) and Glenn “GT” Thompson (R-PA), and Senators Sherrod Brown (D-OH), Susan Collins (R-ME), Bill Nelson (D-FL) and Shelley Moore Capito (R-WV). This legislation ensures that time spent under “observation status” in a hospital counts toward satisfying the three-day inpatient hospital requirement for coverage of skilled nursing care services under Medicare. 

For more information about observation stays and the three-day stay requirement, please visit the AHCA/NCAL website.

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