AHCA Update: 3-Day Waiver and Spell of Illness FAQs


Section 1861(i) of the Act permits Medicare payment for SNF care only when a beneficiary first has an inpatient hospital stay of at least 3 consecutive days. Section 1812(f) of the Act allows Medicare to pay for SNF services without a 3-day qualifying stay if the Secretary finds that doing so will not increase total payments made under the Medicare program or change the essential acute-care nature of the SNF benefit. Based upon the President’s actions and the Secretary’s authority under Section 1135 and Section 1812(f), SNF care without a 3-day inpatient hospital stay will be covered for beneficiaries who experience dislocations or are affected by the emergency.

To view the CMS transmittal, click here. For more information, please email questions to COVID19@ahca.org. AHCA is monitoring its COVID19 email address 7 days a week using that email inbox will ensure quicker response

Source for the full AHCA FAQs