Marie Watteau, the AHA's director of media relations, says, "The rule should be repealed because of the arbitrary requirement that a physician must certify at the time of admission that a Medicare patient is expected to need care in the hospital for a period spanning two midnights to be considered an inpatient. The two-midnight rule undermines medical judgment and disregards the level of care needed to safely treat patients and that is not good for patients."
Watteau says her organization is optimistic about the chances of a repeal. "We would not have filed the lawsuit if we were not confident of the outcome."
Stress for providers and patients
Hospital and health systems leaders are now watching closely to see how the lawsuit plays out.
Kendall Johnson, CFO at 527-bed Baton Rouge (LA) General Medical Center, says he is favor of a repeal because the current rule makes the process too unclear for both patients and providers.
"At the core of this ruling, we find our patients and fellow providers in the middle," he says. "The two-midnight rule poses significant confusion and financial stress to those seeking care, as well as to those providing it. Patients, depending on their admit status, can face heavy hits to their pocketbooks. Physicians and hospitals face unreasonable, predictive ordering and documentation requirements that can negatively impact the course of providing medical care, and in turn, the reimbursement."