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CMS Releases Updated Guidance, Hosts Call on Two-midnight Policy

The Centers for Medicare & Medicaid Services (CMS) released updated frequently asked questions (FAQs) and guidance on the two-midnight policy Nov. 5. The two-midnight policy, which was finalized in the fiscal year 2014 Inpatient Prospective Payment System (IPPS) final rule, establishes a presumption that inpatient hospital stays are reasonable and necessary for Medicare beneficiaries when the hospital stay spans two midnights or more. The updated guidance confirms that recovery audit contracts (RACs) and Medicare administrative contractors (MACs) will not conduct patient status reviews on claims that span two midnights or more if the inpatient admission has a date of service between Oct. 1, 2013 and March 31, 2014. This extends the existing enforcement delay by three months. Members can reference the Special Update on the two-midnight policy for more information.

CMS hosted a call Nov. 12 to provide hospitals and others a chance to ask questions about the two-midnight policy. More information on the call can be found online. Contact Xiaoyi Huang, assistant vice president for policy, at xhuang@essentialhospitals.org or 202-585-0127 with questions.

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