CHA News Article

CMS Updates Guidance on Two-Midnight Policy

Yesterday, the Centers for Medicare & Medicaid Services (CMS) posted updated guidance regarding medical review of inpatient claims in accordance with its two-midnight policy. In the guidance, CMS stated that it will instruct Medicare Administrative Contractors to use its general two-midnight policy when conducting prepayment reviews of claims in which a surgical procedure was canceled. CMS also reiterated that hospitals with claims denied before Jan. 30 under its probe and educate prepayment review process have until Sept. 30 to file a request for redetermination. CHA’s two-midnight resource page has been updated with the new guidance, as well as a transcript and link to a recording of the two-midnight National Provider Call held on Feb. 27. To view these resources, visit www.calhospital.org/resource/inpatient-admission-and-medical-review-resources.

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