S 4641 — Improving Access to Medicare Coverage Act of 2026

Summary

Counts time receiving outpatient observation services in a hospital toward the 3-day minimum hospital stay requirement for Medicare coverage of skilled nursing facility services.
Treats individuals receiving observation services as hospital inpatients for Medicare coverage purposes, even though they retain outpatient status.
Applies to observation services beginning January 1, 2026, and may be applied retroactively to prior periods if an administrative appeal is filed within 90 days of enactment.

AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.

Sponsor (1)

Sen. Collins, Susan M. (R-ME)

5 cosponsors

Money behind the sponsor

Top reported contributors to Susan M. Collins’s campaign committee (2024 cycle) — who funds the bill’s sponsor, not a claim about this bill. Data from FEC.

LOCKHEED MARTIN $54,000
SOUTHWEST AIRLINES $31,205
CHARTER COMMUNICATIONS $22,362
LEGEND SENIOR LIVING $13,200
SENIOR STAR $13,200

Organizations whose employees gave the most — itemized individual contributions grouped by the donor’s reported employer (FEC Schedule A). Full finance for Susan M. Collins → · Outside spending →

Actions (2)

May 21, 2026 Read twice and referred to the Committee on Finance. · senate
May 21, 2026 Introduced in Senate

Related bills (1)

Similar bills (6)

Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.

Text versions (1)

Introduced in Senate · May 21, 2026

Only one text version is on file, so there’s no earlier version to compare against yet.

Full text

IN THE SENATE OF THE UNITED STATES

May 21, 2026

Ms. Collins (for herself, Mr. Welch, and Mrs. Capito) introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the “Improving Access to Medicare Coverage Act of 2026”.

SEC. 2. COUNTING A PERIOD OF RECEIPT OF OUTPATIENT OBSERVATION SERVICES IN A HOSPITAL TOWARD THE 3-DAY INPATIENT HOSPITAL REQUIREMENT FOR COVERAGE OF SKILLED NURSING FACILITY SERVICES UNDER MEDICARE.

(a) In General.—Section 1861(i) of the Social Security Act (42 U.S.C. 1395x(i)) is amended by adding at the end the following: “For purposes of this subsection, an individual receiving outpatient observation services shall be deemed to be an inpatient during such period, and the date such individual ceases receiving such services shall be deemed the hospital discharge date (unless such individual is admitted as a hospital inpatient at the end of such period).”.

(b) Effective Date.—The amendment made by subsection (a) shall apply to receipt of outpatient observation services beginning on or after January 1, 2026, but applies to a period of post-hospital extended care services that was completed before the date of the enactment of this Act only if an administrative appeal is or has been made with respect to such services not later than 90 days after the date of the enactment of this Act. Notwithstanding any other provision of law, the Secretary of Health and Human Services may implement such amendment through an interim final regulation, program instruction, or otherwise. <all>

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