BILL NUMBER: SJR 8	ENROLLED
	BILL TEXT

	ADOPTED IN SENATE  JUNE 1, 2015
	ADOPTED IN ASSEMBLY  AUGUST 17, 2015

INTRODUCED BY   Senator Hernandez

                        MAY 7, 2015

   Relative to Medicare.


	LEGISLATIVE COUNSEL'S DIGEST


   SJR 8, Hernandez. Medicare: observation status.
   This measure would urge Congress and the President of the United
States to reform the short stay admissions criteria for Medicare
beneficiaries and to discontinue the two-midnight policy.




   WHEREAS, The federal Centers for Medicare and Medicaid Services
set rules for hospital stays for Medicare beneficiaries; and
   WHEREAS, These rules govern admissions for the elderly, our most
vulnerable patient population; and
   WHEREAS, Federal guidelines drive physician habits and hospital
policy as Medicare is the largest purveyor of health care in the
state; and
   WHEREAS, The federal Centers for Medicare and Medicaid Services'
guidelines state that patients are not to be formally admitted as a
hospital inpatient unless the physician expects the patient's
condition to warrant a stay of at least two nights; and
   WHEREAS, This "two midnight" determination creates arbitrary
decisions for hospital admissions that are not based on the clinical
condition of the patient but rather an expected length of stay; and
   WHEREAS, Hospital admission decisions should be made by a licensed
physician, assessing the appropriate care for the patient and not an
arbitrary time-driven guideline; and
   WHEREAS, The two-midnight policy has caused many seniors to be
kept in "observation status" without formal admission as a hospital
inpatient; and
   WHEREAS, These patients believe they have been admitted as a
hospital inpatient when in fact they have not, leading to confusion
for both the patient and their family; and
   WHEREAS, Medicare will not pay for skilled nursing facility care
unless a senior has been admitted as a hospital inpatient for at
least three days; and
   WHEREAS, The observation policy, which resulted from the federal
Centers for Medicare and Medicaid Services' guidelines, has denied
seniors the appropriate criteria for admission to skilled nursing
facilities because time spent in "observation status" does not count
as a qualifying hospital admission; and
   WHEREAS, The observation stay practice is not in the best
interests of patients, hospitals, and health care professionals; now,
therefore, be it
   Resolved by the Senate and the Assembly of the State of
California, jointly, That the Legislature respectfully urges Congress
and the President of the United States to reform the short stay
admissions criteria to more accurately reflect the clinical needs of
a patient as determined by a physician and to discontinue the
two-midnight policy that is currently in place; and be it further
   Resolved, That the Secretary of the Senate transmit copies of this
resolution to the President and Vice President of the United States,
to the Speaker of the House of Representatives, to the Majority
Leader of the Senate, and to each Senator and Representative from
California in the Congress of the United States.