AAPACN received clarifying information from the Centers for Medicare & Medicaid Services (CMS) related to the end of the COVID-19 public health emergency (PHE) and how residents covered under Medicare Part A using the 3-day qualifying hospital stay (QHS) waiver would be impacted after May 11, 2023.
CMS provided the following clarifying information:
A resident who accessed Medicare Part A extended care coverage in a SNF via the QHS waiver does not qualify for the 30-day transfer rule on May 12 or later.
Rationale:
The 30-day transfer rule is outlined in §20.2 of the Medicare Benefit Policy Manual, chapter 8. Section 20.2.3 specifically addresses the 30-day transfer rule as it relates to a readmission to a SNF after a post-hospital extended care SNF stay.
CMS clarified, “When using [the 3-day QHS] waiver, the services are, as stated in §1812(f), extended care services that are not post-hospital, which makes them different in kind from services covered under §1861(i) and the 30-day transfer rule would not apply.”
Therefore, stays using the 3-day QHS waiver do not meet the criteria to apply the 30-day transfer rule.
For permission to use or reproduce this tip in full or in part, please complete a permissions form.