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CMS posts additional guidance on two-midnight policy, audits

March 7, 2014

The Centers for Medicare & Medicaid Services (CMS) Feb. 24 posted additional guidance regarding its two-midnight policy and related Probe & Educate audits.

Specifically, CMS said it will require Medicare Administrative Contractors to re-review all claims denied to date under the Probe & Educate process to ensure that the decisions and subsequent education were consistent with the agency’s clarifications on Jan. 30. In addition, CMS released preliminary data related to the Probe & Educate audit process, including examples of common claim denials during the process.

The agency also has updated its website to include instructions for how the two-midnight policy will apply to hospital transfers and off-campus emergency departments. For more, click on: http://tinyurl.com/nybobqc.