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MedPAC to Review Two-Midnight Rule

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.

Please contact Xiaoyi Huang, JD, director of policy, at or 202.585.0127 with questions.


About the Author

Matt Buechner is the policy and advocacy associate for America's Essential Hospitals.

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