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CMS Extends Two-Midnight Delay for Additional Six Months

The Centers for Medicare & Medicaid Services (CMS) posted further guidance extending the partial delay of the two-midnight policy for inpatient admission and medical review through Sept. 30. For inpatient admissions with dates of service between Oct. 1, 2013 and Sept. 30, 2014, recovery audit contractors and Medicare administrative contractors (MACs) will not conduct postpayment patient status reviews. During this time MACs will continue to conduct prepayment probe reviews for a sample of 10 claims per hospital (25 claims for large hospitals).

CMS also released more information on the claims review policy and the physician certification and order requirements under the two-midnight policy late last month.


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