OIG report: VULNERABILITIES REMAIN UNDER MEDICARE'S 2-MIDNIGHT HOSPITAL POLICY
Date Posted: Tuesday,
December 20, 2016
What OIG Found OIG found that the number of inpatient stays decreased and the number of outpatient stays increased since the implementation of the 2-midnight policy. Further, short inpatient stays decreased more than long outpatient stays.
However, despite these changes, vulnerabilities still exist.
- Hospitals are billing for many short inpatient stays that are potentially inappropriate under the policy; Medicare paid almost $2.9 billion for these stays in FY 2014.
- Medicare pays more for some short inpatient stays than for short outpatient stays, although the stays are for similar reasons.
- Hospitals continue to bill for a large number of long outpatient stays.
- An increased number of beneficiaries in outpatient stays pay more and have limited access to SNF services than they would as inpatients.
- Hospitals continue to vary in how they use inpatient and outpatient stays.