Hospitals Welcome Two-Midnight Rule Delay
Providers are pleased that CMS is delaying enforcement of new guidelines governing Medicare reimbursements for short-term hospital stays, but they insist the new rule is flawed and say they will continue to oppose it.
CMS's decision late Friday to delay full implementation of a new rule that reforms Medicare reimbursement for short-term hospital admissions is drawing cautious praise from providers and their allies in Washington, D.C.
In the announcement, officials at the Centers for Medicare & Medicaid Services stated that they are extending the so-called two-midnight rule's "probe and educate" transition period to the end of the federal fiscal year on Sept. 30. Full enforcement of the policy had been slated to begin in April.
"Hopefully, the two-midnights [rule] delay is a recognition that we do need to go back to the table… and seniors will know what their costs are going to be," said Lori Prater, legislative counsel to U.S. Rep. Jim Gerlach, a Pennsylvania Republican who has been pushing for delay and revision of the new rule since December.
Under the rule, which CMS issued in August 2013, hospitals that admit patients for less than two nights will receive reimbursement at Medicare B outpatient rates. The rule states that hospital admissions shorter than two midnights in length are "generally inappropriate for payment under Medicare Part A, regardless of the hours the patient came to the hospital or whether the patient used a bed."