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Feb 3.—The Centers for Medicare & Medicaid Services (CMS) delayed for an additional six months enforcement of its new Medicare hospital admissions policy.
In a notice posted on the CMS website recently, the agency announced that Medicare administrative contractors (MACs) will continue to “probe and educate” acute care hospitals, long term care hospitals (LTCHs) and inpatient psychiatric facilities (IPFs) on the so-called two-midnight rule.
The two-midnight rule established new inpatient hospital admission requirements under Medicare Part A that required each physician to document that they expect the beneficiary to require a stay of at least two midnights and admit the patient based on that expectation.
The new admissions requirements, which were laid out by the FY14 IPPS final rule issued in August 2013, were originally supposed to go into effect Oct. 1, 2013 but they were delayed in the fall until April 1.
The latest delay, until Oct. 1, 2014, will keep recovery audit contractors (RACs) from conducting pre-payment patient status reviews of admissions that began after September 2013. However, RACs may continue to conduct CMS-approved claim reviews that are unrelated to inpatient admission decisions.
Additionally, CMS will not conduct post-payment patient status reviews of admissions starting October 1, 2013, through October 1, 2014.
CMS specified that it will conduct prepayment patient status probe reviews of admissions beginning Oct. 1, 2013, during the delay. Also unaffected by the delay are other types of inpatient reviews by MACs, RACs and supplemental medical review contractors, such whether inpatient hospital admissions before October 2013 met the previous admission requirements. RAC s also will continue reviews of less-than two midnight stays.
The CMS also will hold a conference call Feb. 4 to discuss details of the two-midnight policy with providers.
The delay was welcomed by hospital advocates.
“This action clearly recognizes that there are still many unanswered questions about the policy,” Rick Pollack, executive vice president for the American Hospital Association, said in a written statement. “At the same time, we continue to urge CMS to fix the critical flaws of the underlying policy by immediately engaging stakeholders to find a workable solution that addresses the reasonable and necessary inpatient-level services currently provided by hospitals to Medicare beneficiaries that are not expected to span two midnights.”
The CMS delay followed the recent introduction of legislation to delay the two-midnight reviews until October 2014, as well as a push for a judicial review on the policy.
The enforcement delay will not include suspension of a 0.2 percent cut in FY14 IPPS standardized payment amounts, according to a CMS official. Those reductions were implemented to reflect anticipated savings of the two-midnight policy change.
Publication Date: Monday, February 03, 2014
Brian Kueppers, founder and CEO, Apex, discusses the importance of a robust patient payment strategy in boosting organization revenue and enhancing patient satisfaction.
Brian Grazzini, CFO, HealthPort, describes the importance of efficient and compliant information exchange and audit management in helping HIM staff spend less time on paperwork and more on mission-critical projects.
Cindy Matthews, executive vice president, Community Hospital Corporation, discusses how rural and community hospitals can use collaborative partnering to position for success through tough market conditions.
Rick Heise, senior vice president, revenue cycle, at Cerner Corporation, discusses the importance of integrating clinical and financial data to excel in health care’s changing payment environment.
Dale Hockel, senior vice president of operations, and Jim Fanelli, CFO, TriMedx, share strategies for elevating clinical engineering through innovative management programs.
Russ Graney, founder and CEO for Aidin, and John Laursen, head of business development for Aidin, share insights on how to improve care transitions between acute and post-acute care settings and incentivize high-quality patient outcomes.
Scott Elston, strategic accounts manager, GE Healthcare Services, describes how substantial cost reduction in health care requires rethinking business strategy and asset use.
Robert Williams, MD, director, Deloitte Consulting LLP, and Arielle Freiberger, product strategist, ConvergeHEALTH by Deloitte, explain how sophisticated retrospective, real-time, and predictive data analytics can inform decision making to reduce costs and improve care.
Stuart Hanson, director of business development (healthcare solutions) at Citi Retail Services, discusses how improving the payment experience can benefit consumers and healthcare providers.
Scott Schmidt, vice president, Cerner RevWorks, LLC, shares insights on best practices for maximizing a revenue cycle management partnership.
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