CMS delays RAC enforcement of ‘two-midnight’ rule

CMS has announced the prohibition of Recovery Audit Contractor inpatient hospital patient status reviews under the “two-midnight” policy until April 30.

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The current statutory prohibition expired March 31, according to the American Hospital Association.  

In a 392-37 vote, the House overwhelmingly voted in favor of legislation that repeals the sustainable growth rate in late March. The measure also includes a six-month partial enforcement delay of the two-midnight policy.

The Senate, which reconvenes April 13, still needs to vote on the legislation.

Under the two-midnight rule, CMS generally considers hospital stays of less than two midnights to be outpatient cases, while stays spanning two midnights are appropriate for payment under the inpatient prospective payment system rule.

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