Press Release

June 24, 2015
Three Cardin Bills Approved By Senate Finance Committee Support Patients and Improve Access to Health Care

WASHINGTONU.S. Senator Ben Cardin (D-Md.), a member of the Senate Finance Subcommittee on Health Care, thanked his colleagues on the Senate Finance Committee for their bipartisan work Wednesday to advance three bills he has introduced to better protect seniors.  The bills are designed to prevent patients from receiving unexpected bills for post-acute care in a skilled nursing facility; improve access to emergency psychiatric care for individuals with severe mental illness; and provide home- and community-based services to low-income, Medicare-only beneficiaries to allow them to remain in their homes rather than having to enter nursing homes. The three bills will now be considered by the full Senate.


“Commonsense changes can save Americans from additional trauma during and after some of the most vulnerable times of their lives,” said Senator Cardin. “The reforms of the Affordable Care Act have had a positive impact on our health care system, but we can and should be doing more.”


The Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act (S. 1349)  is designed to save seniors under Medicare Part A the sticker shock that comes after they are discharged from the hospital and realize that Medicare will not cover the cost of post-acute care in a skilled nursing facility, simply because their overnight stays in a hospital were classified as outpatient observation instead of inpatient admissions. This no-cost legislation would require hospitals to notify Medicare beneficiaries of their outpatient status within 36 hours or, if sooner, upon discharge. Outpatient status affects a patient’s ability to receive Medicare coverage for post-acute care in a skilled nursing facility after discharge from the hospital, as well as copayments and prescription drug costs. The legislation is cosponsored by Senator Mike Enzi (R-R-Wyo.).


The Improving Access to Emergency Psychiatric Care Act of 2015 (S.599) would extend the current three-year Medicaid Emergency Psychiatric Demonstration Project, which is providing timely, cost-effective and life-saving care to individuals who are experiencing an emergency psychiatric crisis.  In 2010, Congress authorized this demonstration project to alleviate the shortage of psychiatric beds by allowing federal Medicaid matching payments to freestanding psychiatric hospitals for emergency psychiatric cases, waiving the longstanding Institution for Mental Disease (IMD) exclusion for Medicaid beneficiaries between the ages of 21 and 64 years.  In Maryland and 10 other participating states, as well as the District of Columbia, this demonstration project is allowing Medicaid beneficiaries with severe mental illness to receive emergency inpatient treatment in community psychiatric hospitals. Despite very promising preliminary results, the demonstration is set to end on December 31, 2015. The legislation would build on the early success of this demonstration by extending the program through September 30, 2016, when the Secretary of Health and Human Services (HHS) would be required to submit a report to Congress with her recommendations based on the final evaluation.  After the report is submitted to Congress, the Act would also allow the Secretary of HHS to extend the program for additional three years and/or expand it to include other states. At the completion of those three additional years, the project would come to a close unless Congress acts to extend it. All the while, the demonstration would be required to remain budget neutral. The legislation is cosponsored by Senators Pat Toomey (R-Pa.) and Susan Collins (R-Maine).


The Community Based Independence for Seniors Act (S. 704) would establish a new Community-Based Institutional Special Needs Plan (CBI-SNP) demonstration project.  This demonstration would target home- and community-based services for low-income, Medicare-only beneficiaries who need help with two or more activities of daily living, the usual criteria for nursing home eligibility. The plans would tailor services to beneficiaries, depending on individual needs.  For instance, they might provide assistance with bathing or dressing, housekeeping or transportation, or even respite care for their primary caregiver. The goal is to prevent these Americans from having to enter an institution and spend down their remaining assets, thereby becoming eligible for Medicaid. It would help our seniors remain in their own homes, where studies show they wish to remain. The legislation is sponsored by Senator Chuck Grassley (R-Iowa).