The Medicare Payment Advisory Commission (MedPAC) announced that it will look into alternatives for the two-midnight inpatient admission policy. Currently, the two-midnight policy presumes inpatient admissions that last for fewer than two midnights are inappropriate for Medicare inpatient reimbursement, with these stays subject to scrutiny by Centers for Medicare & Medicaid Services (CMS) contractors. Concerns about the rule have previously caused CMS and Congress to delay enforcement of the rule until March 31, 2015.
Alternatives to the two-midnight policy would amend the inpatient payment system to clarify when a patient is considered an inpatient and alter payment mechanisms to require less observation care. Mark Miller, PhD, executive director for MedPAC, told legislators at a House Ways and Means Health Subcommittee hearing that the commission may make official recommendations. Miller explained that more information would be available when the committee convenes again in the fall.
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