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Final two-midnight rule dismisses suggestions on ‘physician judgment’
Modern Healthcare

The CMS is standing by the controversial two-midnight rule and will not implement changes proposed by industry stakeholders, including a popular suggestion to create a one-midnight rule. The agency will also allow physicians to exercise judgment in admitting patients for short hospital stays.

The CMS finalized its two-midnight policy in the 2016 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System payment rule released Friday.

The two-midnight rule, which was created in 2013, calls for Medicare’s payment and audit contractors to assume a hospital admission was legitimate if it spans two midnights. Shorter stays are assumed to be more appropriately billed as outpatient observation care.