February 18, 2014
Due to fierce opposition from those in the healthcare industry, CMS is delaying the two-midnight rule until October.
The two-midnight rule, a new regulation in Medicare attempting to ensure that patients are not admitted to the hospital unnecessarily, establishes that inpatients who span two midnights or more are qualified for Medicare Part A payments. Inpatients who stay less than two midnights are to be billed as outpatients.
Though CMS will not be enforcing the two-midnight rule until October and Medicare administrative contractors (MACs) and recovery auditors (RACs) will not be conducting post-payment reviews of claims dated from October 1, 2013 to October 1, 2014, they will conduct pre-payment reviews of the admissions that occur after March 31, 2014 through the end of September.
While the two-midnight rule will still be enforced in October, the current delay is a welcome one.