CMS limits look-back period for two-midnight reviews

CMS has issued additional information on its pause of Beneficiary and Family Centered Care Quality Improvement Organizations' claim audits under the two-midnight inpatient admissions rule.

CMS halted the audits May 4 after becoming aware of inconsistencies in the application of the two-midnight policy for short hospital stay reviews.

On Thursday, CMS said the pause in audits is still in effect. When the audits resume, CMS said the reviews will be limited to a six-month look-back period from the date of admission. 

"The imposition of a six-month look-back period for claims impacted by the temporary suspension of the BFCC reviews is being implemented to help ensure that providers receiving denials for Part A claims have sufficient time to rebill under Medicare Part B," said CMS.

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