Two-midnight Rule Challenged by Industry Groups

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  • January 24, 2014
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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.

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Brad Ericson
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Brad Ericson, MPC, CPC, COSC, is a seasoned healthcare writer and editor. He directed publishing at AAPC for nearly 12 years and worked at Ingenix for 13 years and Aetna Health Plans prior to that. He has been writing and publishing about healthcare since 1979. He received his Bachelor's in Journalism from Idaho State University and his Master's of Professional Communication degree from Westminster College of Salt Lake City.

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