The Centers for Medicare and Medicaid Services (“CMS”) is the federal agency that oversees the Medicare and Medicaid programs. On March 13, 2020, CMS made a number of rule changes that should help streamline the Medicare system for beneficiaries who need to access Medicare benefits during the COVID-19 outbreak. One element of the CMS rule changes will improve Medicare beneficiaries’ access to Medicare Skilled Nursing Facility (“SNF”) services.
Traditional Medicare SNF Rules
Traditionally, a Medicare beneficiary who requires skilled services in a nursing facility is only eligible for SNF services within 30 days of a three-day qualifying hospital stay. Traditional SNF benefit rules provide that skilled care may be provided during the benefit period for “up to 100 days” as long as there is a need for skilled care. The benefit period is limited to a “spell of illness” which begins on the date SNF benefits are provided and ends when the Medicare beneficiary has been out of a hospital and/or SNF inpatient setting for 60-consecutive days.