Two-Midnight Rule Must be Fixed or Replaced, Say Providers
CMS has issued a clarification on its rule governing how Medicare classifies and pays for short hospital stays, but healthcare providers are still crying foul over the new standard.
A top policy official at the American Hospital Association says last week's Two Midnight Rule guidance letter from federal officials provides welcomed clarifications but leaves the policy fundamentally flawed.
"This is guidance that hospitals have been waiting for," said Priya Bathija, senior associate director of policy at the AHA. "It's been very hard for hospitals to operationalize Two Midnights without the guidance."
She praised the directive in the Feb. 24 guidance letter calling on Medicare Administrative Contractors to "re-review" all claim denials under the Two Midnight Rule's probe and educate process prior to Jan. 30. The Centers for Medicare & Medicaid Services says the MAC claim denial re-reviews are supposed "to ensure the claim decision and subsequent education is consistent with the most recent clarifications. The MAC may reverse their decision and issue payment outside of the appeals process if the MAC determines that a claim is payable upon re-review."
Last week's guidance letter from CMS is the second is less than a month. On Jan. 30, CMS issued a guidance letter that included an update on physician certification of short-term hospital stays.
- Antibiotic Overuse a 'Huge Threat' to Patient Safety, Says CDC
- CFO Exchange: Smartphones Poised to Disrupt Healthcare, Says Topol
- Consumerism Drives Healthcare Branding, Rebranding Efforts
- 3 Traits Personality Assessments Can't Reveal
- PA Ranks See 'Phenomenal Growth,' Lack of Diversity
- CHS Hacked, 4.5M Patient Records Compromised
- CFO Exchange: Healthcare Leaders Share 5 Innovative Ideas
- Business Roundup: M&A Activity Down Slightly in First Half of 2014
- Large Employers Trimming Healthcare Spending
- Carondelet to Pay $35M to Settle Fraud Allegations