CHA News Article

Enforcement Delay of Two-Midnight Policy Extended Through Sept. 30

A provision to continue delaying full enforcement of the two-midnight policy for an additional six months, through Sept. 30, 2015, was included in the Medicare Access and CHIP Reauthorization Act (H.R. 2) legislation passed by the Senate this week. During the partial enforcement delay, recovery audit contractors will not be able to conduct patient status for inpatient claims with dates of admission Oct. 1, 2013, through Sept. 30, 2015. The Centers for Medicare & Medicaid Services (CMS) will, however, be permitted to continue its “probe and educate” audits, as previously specified by the agency, through Sept. 30.

CHA continues to advocate for alternative solutions to the two-midnight policy and will monitor the probe and educate activities undertaken by Noridian. CHA welcomes member comments on this policy and the education being provided by the Medicare contractors. CHA expects some discussion of the policy in the forthcoming federal fiscal year 2016 inpatient prospective payment system proposed rule, scheduled to be released this month.

Hospital resources related to the two-midnight policy are available at www.calhospital.org/resource/inpatient-admission-and-medical-review-resources.

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