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Senate bill to delay two-midnight enforcement introduced

March 7, 2014

Sens. Robert Menendez, D-N.J., and Deb Fischer, R-Neb., March 5 introduced the AHA-backed Two-Midnight Rule Coordination and Improvement Act, S. 2082. The bill would put the brakes on enforcement of the Centers for Medicare & Medicaid Services’ (CMS) Medicare inpatient admission and review criteria – better known as the “twomidnight policy” – and direct CMS to develop new criterion for short inpatient stays.

Under the controversial policy, hospital stays that span two or more midnights are to be considered appropriate for inpatient admission and Medicare would pay hospitals the inpatient rate. Hospital services that are expected to span less than two midnights will generally be treated as outpatient services and paid at the lower outpatient rate. The policy is slated to take full effect in October. Hospital leaders fault the policy for being confusing and difficult to implement. The AHA strongly backs S. 2082, calling the CMS policy “bad news for seniors.”