On Monday, Linda and I did a talk at the State Bar Foundation on the “Medicare Medicaid Maze.” One of the issues that attendees were very concerned about was the issue of Medicare Observation Status and how that impacts Medicare payment for post-acute rehabilitation. Medicare law requires beneficiaries to stay at least three days as a hospital inpatient before the entitlement program will cover postacute care in a nursing facility. Hospital care while in observation, technically an outpatient service, does not count toward the minimum for skilled nursing facility coverage. Patients without at least three inpatient days must pay out of their own pocket for postacute facility care out of pocket. However, some lawmakers want to change this. The Improving Access to Medicare Coverage Act would end “observation status” and make all time in the hospital “equal time” for purposes of Medicare paying for post-hospital care.