Last week, America’s Essential Hospitals submitted comments for the record to the House Committee on Ways and Means in response to their May 20 hearing regarding hospital payment issues in the Medicare program.
The committee’s hearing focused on the two-midnight rule, current incentives for short inpatient stays, and recovery audit contractor (RAC) auditing. Congress recently passed legislation requiring the Centers for Medicare & Medicaid Services (CMS) to delay enforcement of the two-midnight rule until March 31, 2015, due to concerns with implementation. America’s Essential Hospitals’ comments were consistent with previous communications to the administration around these issues. The association encouraged CMS to engage with stakeholders to revise the two-midnight policy to preserve physicians’ judgment of the most appropriate level of care. We also recommended CMS allow skilled nursing facility coverage during the observation period to count toward a patient’s admitted status, and asked that stays lasting more than two midnights be deemed reasonable and necessary for inpatient admissions, and thus not subject to excessive review authority by RACs provided there is no indication of fraud or abuse.