As part of the 2014 inpatient prospective payment system final rule, CMS formulated a “2-midnight presumption” and a “2-midnight benchmark” (collectively the “2-Midnight Rule”) to guide admitting practitioners and review contractors on when it is appropriate to admit a patient as a hospital inpatient. In the last few days, CMS posted a series of documents to its website containing additional guidance related to the 2-Midnight Rule.
One significant change contained in the new guidance is an extension of the delay in the enforcement of the 2-Midnight Rule through March 31, 2014. According to the new guidance, except as noted below, Medicare Administrative Contractors and Recovery Audit Contractors will not conduct reviews for compliance with the 2-Midnight Rule for claims with dates of admission between October 1, 2013 and March 31, 2014 (rather than December 31, 2013). During this same period, Medicare Administrative Contractors will review inpatient stays of less than 2 midnights during a series of “probe and educate” audits to determine hospitals’ compliance with the 2-Midnight Rule. CMS updated its previously released FAQ on the delay to reflect the extension.
CMS also provided additional FAQs related to the 2-Midnight Rule and information on how the “probe and educate” audits will be conducted by Medicare Administrative Contractors.
Hall Render previously released an article on the implementation of the 2-Midnight Rule, which is available here, and an article on the delay in the enforcement of the 2-Midnight Rule, which is available here.
Should you have any questions about the 2-Midnight Rule, please contact:
- Lori A. Wink at 414-721-0456 or lwink@hallrender.com;
- Joseph R. Krause at 414-721-0906 or jkrause@hallrender.com; or
- Your regular Hall Render attorney.
