CMS Quietly Postpones Enforcement of Two-Midnight Rule to April 1

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The Centers for Medicare and Medicaid Services (CMS) have delayed enforcement of the controversial two-midnight rule for another three months to April 1, 2014.

In late September CMS had announced it was relaxing enforcement of the provision, which went into effect Oct. 1, until Jan. 1, 2014. Earlier this week CMS published additional guidance that pushed that date back three months.

From the outset, healthcare providers have protested against the rule, which requires Medicare patients to spend two midnights in a hospital to achieve inpatient status. CMS has resisted calls to change the new rule.

“CMS will conduct prepayment patient status probe reviews for dates of admission on or after October 1, 2013 but before March 31, 2014,” according to CMS’s website. “Medicare Administrative Contractors (MACs) will conduct patient status reviews using a probe and educate strategy for claims submitted by acute care inpatient hospital facilities, Long Term Care Hospitals (LTCHs) and Inpatient Psychiatric Facilities (IPFs) for dates of admission on or after October 1, 2013 but before March 31, 2014 … In general, CMS will not conduct post-payment patient status reviews for claims with dates of admission October 1, 2013 through March 31, 2014.”

CMS has updated its FAQ explaining how it has implemented and will enforce the two-midnight rule here.

 

 

 

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Posted in Billing and Coding, Denials Management, Medical Receivables, Patient Financial Services .

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