Citizen Group Opposes Temporary Medicare Audit Suspension

Citizens Against Government Waste has urged Congress to reinstate all Medicare recovery audits of short-stay hospital inpatient claims in response to CMS guidance concerning the new two-midnight admissions rule.

The regulation generally considers inpatient admissions spanning two midnights as qualifying for payment under Medicare Part A. CMS included the rule in its final rule on 2014 Medicare inpatient prospective payment system rates.

The agency recently issued guidance stating it won't conduct post-payment patient status reviews for claims with dates of admission from Oct. 1, 2013 through March 31, 2014 — three months longer than previously indicated — as providers adapt to the new regulation.

CAGW views this policy wasteful. The group has stated the "regulatory interference" with the Medicare recovery auditor, or RAC, program will cause Medicare to lose $2 billion, according to a CAGW news release.

The Medicare RAC program began in 2009 and has recovered more than $7 billion in improper payments so far.

"At a time when the national debt exceeds $17 trillion, taxpayers simply cannot afford the unjustified delay of an audit program that has thus far proven to be extremely successful at reducing wasteful spending," the agency wrote in its letters to lawmakers.

More Articles on Medicare Payments:
CMS Issues Additional Guidance on Two-Midnight Hospital Admissions Rule
CMS Issues Guidance On "Two Midnights" Hospital Payment Rule
House Lawmakers: Delay Medicare "Two Midnights" Rule for Hospital Stays 

Copyright © 2023 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars