State Seeks Waiver from Three-Day Rule

With the input of several health care provider groups, including the Home Care Alliance, the state sent a letter on July 23rd to CMS Administrator Marilyn Tavenner officially requesting a waiver from the so-called “three-day rule.”

The rule refers to Medicare’s requirement that post-hospital extended care services in a skilled nursing facility are not allowed unless they are preceded by a hospital inpatient stay lasting three consecutive days. The Home Care Alliance joined other groups like Mass. Hospital Association, Mass. Senior Care Association, Mass. Medical Society and others in voicing support for such a waiver in multiple stakeholder meetings.

The idea is that patients can be properly directed to skilled nursing facility care and/or home health services, but eventually and ideally transitioning back into the community. All the while, patients would receive an appropriate level of care and avoid unnecessary hospitalizations.

The state’s Executive Office of Health and Human Services asks that the waiver include Medicare Fee-for-Service patients and last for three to five years.

The Home Care Alliance will continue to monitor the state’s request and provide updates.

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One thought on “State Seeks Waiver from Three-Day Rule”

  1. This is a HUGE issue for our patients and their families! Thank you for taking the lead in advocating for this waiver!

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