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S. 4641
U.S. Senate•In Senate Committee
Summary
S. 4641, the Improving Access to Medicare Coverage Act of 2026, was introduced in the Senate on May 21, 2026 by Sen. Susan Collins (R) with 6 co-sponsors. It was referred to Finance, and last saw action on May 21, 2026: Read twice and referred to the Committee on Finance.
Record
Text
S. 4641 has 6 co-sponsors.
sb4641/introduced-in-senate.txt119 S4641 IS: Improving Access to Medicare Coverage Act of 2026U.S. Senate2026-05-21text/xmlENPursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.II 119th CONGRESS 2d Session S. 4641 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 BILLTo 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.1.Short titleThis Act may be cited as the Improving Access to Medicare Coverage Act of 2026 .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 generalSection 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 dateThe 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.
Tracker
The tracker indicates the progress of this legislation as it moves through the legislative process.
- Introduced2026-05-21
- Passed Senate
- Passed House
- Conference
- To President
- Became Law
CRS Summary
The summaries are the Congressional Research Service’s, one per stage. Read them in full.
Introduced in Senate May 21, 2026
sb4641/introduced-in-senate.mdShown Here:
Introduced in Senate (05/21/2026)
Improving Access to Medicare Coverage Act of 2026
This bill deems an individual receiving outpatient observation services in a hospital as an inpatient for purposes of satisfying the three-day inpatient hospital-stay requirement with respect to Medicare coverage of skilled nursing facility (SNF) services. (Generally, individuals must have been an inpatient at a hospital for at least three days in order to qualify for SNF services. An individual's time spent under observation at a hospital for purposes of determining whether the individual should be admitted does not count towards this requirement.)
Sponsors
Sen. Susan Collins (R) sponsors S. 4641, and 6 members have co-sponsored it, 2 of them from the day it was introduced.

Sen. · R–ME · Sponsor
Introduced May 21, 2026

Sen. · R–WV · Co-sponsor
Joined May 21, 2026 · Original

Sen. · D–VT · Co-sponsor
Joined May 21, 2026 · Original

Sen. · R–AL · Co-sponsor
Joined Jun 15, 2026

Sen. · D–CA · Co-sponsor
Joined Jun 23, 2026

Sen. · D–RI · Co-sponsor
Joined Jun 23, 2026

Sen. · D–DE · Co-sponsor
Joined Jul 28, 2026
Committees
S. 4641 went before 1 committee: Finance.
Actions
S. 4641 has taken 2 actions since May 21, 2026.
| Chamber | Action | |||
|---|---|---|---|---|
May 21, 2026 | Senate | Read twice and referred to the Committee on Finance.Finance Committee | ||
May 21, 2026 | — | Introduced in Senate |
Votes
S. 4641 has not gone to a roll call.
Related bills
1 bill is related to S. 4641.
Titles
S. 4641 goes by 3 titles, 1 of them short titles.
- Improving Access to Medicare Coverage Act of 2026 — Display Title
- Improving Access to Medicare Coverage Act of 2026 — Short Title(s) as Introduced
- 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. — Official Title as Introduced
Lobbying
3 clients hired 3 firms and 12 registered lobbyists who named S. 4641 in 3 quarterly filings, 2026. Reported under the Lobbying Disclosure Act; a filing’s income covers everything its registrant worked that quarter, so the amounts below are the filings’, not this bill’s.
Filed under Health Issues, Medicare/Medicaid, Housing, Immigration, Labor Issues/Antitrust/Workplace, Trade (domestic/foreign), Veterans.
Clients
Who paid to be heard, by how many filings named the bill.
| Client | Business | State | Firms | Filings | Reported |
|---|---|---|---|---|---|
| AMERICAN HEALTH CARE ASSOCIATION | — | District of Columbia | 1 | 1 | — |
| DIRECT SUPPLY, INC. | — | Wisconsin | 1 | 1 | — |
| MEDLINE | Medical product manufacturing and distribution | Illinois | 1 | 1 | — |
Firms
Registrants who filed on the bill, by filings.
| Registrant | Clients | Filings | Reported |
|---|---|---|---|
| AMERICAN HEALTH CARE ASSOCIATION | 1 | 1 | — |
| DIRECT SUPPLY, INC. | 1 | 1 | — |
| MEDLINE | 1 | 1 | — |
Lobbyists
Named on the filings that cite the bill.
| Lobbyist | Firms | Clients | Filings |
|---|---|---|---|
| AARON WINTERS | 1 | 1 | 1 |
| BRIAN PERRY | 1 | 1 | 1 |
| CHRISTOPHER DONNELLAN | 1 | 1 | 1 |
| CLIFTON PORTER | 1 | 1 | 1 |
| DANA HALVORSON RITCHIE | 1 | 1 | 1 |
| ERICA MILLER | 1 | 1 | 1 |
| GENEVIEVE HILLIS | 1 | 1 | 1 |
| JENNIFER HAHS | 1 | 1 | 1 |
| MICHAEL BASSETT | 1 | 1 | 1 |
| NISHA HAMMEL | 1 | 1 | 1 |
| ROBERT CALIA | 1 | 1 | 1 |
| RYAN MCNAMARA | 1 | 1 | 1 |
Filings
The documents themselves, on the Senate’s Lobbying Disclosure site, largest reported first.
| Client | Registrant | Period | Reported | Document |
|---|---|---|---|---|
| AMERICAN HEALTH CARE ASSOCIATION | AMERICAN HEALTH CARE ASSOCIATION | 2026 second_quarter | $840K | 2nd Quarter - Report |
| MEDLINE | MEDLINE | 2026 second_quarter | $400K | 2nd Quarter - Report |
| DIRECT SUPPLY, INC. | DIRECT SUPPLY, INC. | 2026 second_quarter | $230K | 2nd Quarter - Report |
Classification
The Congressional Research Service files S. 4641 under Health, one of its 31 policy areas.
CRS Subjects
CRS assigns every bill one policy area from its 31; S. 4641’s is Health.
s4641/policy-areas.txtSource: congress.gov · legiscan.com
