CMS Updates Two-Midnight Guidance

CMS has updated its two-midnight rule guidance to reflect the six-month enforcement delay enacted with the passage of the Protecting Access to Medicare Act of 2014.

In its updated guidance, CMS states medical review activities conducted as part of the Medicare administrative contractor probe and educate process will continue through March 31, 2015. Additionally, recovery auditors are prohibited from conducting inpatient hospital patient status reviews on claims with dates of admission from Oct. 1, 2013 to March 31, 2015.

The two-midnight rule was established by last year's Medicare inpatient prospective payment system rule. According to the policy, inpatient stays lasting fewer than two midnights must be treated and billed as outpatient services. CMS introduced the policy to better monitor Medicare reimbursement for short inpatient stays and ensure inpatient admissions are medically necessary. The American Hospital Association and several health systems have sued CMS, arguing the rule is "arbitrary" and "capricious." Enforcement was previously scheduled to begin this October.

More Articles on the Two-Midnight Rule:
Hospitals Take CMS' Two-Midnight Rule to Federal Court  
Obama Signs SGR Patch, Delay of Two-Midnight Rule Into Law  
Senate Passes Bill Delaying SGR Cuts, Two-Midnight Rule 

 

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