Two-midnight Rule Challenged by Industry Groups
Hospitals and their associations are taking legal action against the Centers for Medicare & Medicaid Services (CMS) over the agency’s recently implemented two-midnight rule, the American Hospital Association said. The group argues CMS neither provided reasonable explanation for the action, nor failed to follow regulations outlining notice and comment.
The two-midnight rule, launched last year, requires hospitals to admit patients as inpatients for two nights to get beyond the short stay threshold, which has become a red flag for auditors. CMS argues the changes were made to clarify the threshold and has ordered recovery audit contractors (RACs) not to review any short-stay claims that span beyond two midnights.
To offset the cost of audits made to assure hospitals are complying, CMS set a 0.2 percent rate cut in the Inpatient Prospective Payment System (IPPS) payment for 2014.