Significant Proposed Changes to the 2 Midnight Rule

CMS has agreed to work with the Medicare provider community regarding a solution to the confusion created with the implementation of the “2 midnight rule.”  This rule was introduced in the 2014 Inpatient Prospective Payment System Rule (IPPS) and several hospitals and physicians around the country struggled with the many nuances and operational changes that were required to comply.  In the 2015 Proposed IPPS, CMS announced its intention to work with providers to define and establish new payment methodologies for short inpatient admissions.

In testimony this week, CMS Deputy Administrator Sean Cavanaugh told the House Subcommittee on Health that the agency is interested is soliciting public comments about alternative payment systems that could define hospital short-stays precisely and consistently.  This appears to send a strong message to providers that CMS is very interested in refining the “2 midnight rule” and developing more efficient means of determining appropriate payment for these difficult cases.

To read the entire proposed IPPS: http://ofr.gov/OFRUpload/OFRData/2014-10067_PI.pdf

HC Healthcare Consulting has extensive expertise in coding and billing compliance. Our staff includes certified coders, consultants certified in healthcare compliance, and certified public accountants that are available to provide expert assistance with your ICD-10 implementation efforts, including physician and staff documentation and coding training.  We are also available to assist with your ongoing compliance needs.

DISCLAIMER:  This post contains only summary information and highlights; it should be read in conjunction with the full article or document provided as a link.  Any advice or recommendations given is general and specific questions should be directed to professional counsel.

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