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Senate bill would extend two-midnight partial enforcement delay

March 6, 2014

Sens. Robert Menendez (D-NJ) and Deb Fischer (R-NE) yesterday introduced the Two-Midnight Rule Coordination and Improvement Act (S. 2082). The AHA-supported legislation would require CMS to implement a new payment methodology for short inpatient stays in FY 2015. The bill would also extend the partial delay in enforcement of the Centers for Medicare & Medicaid Services’ two-midnight policy to the earlier of Oct. 1, 2015 or when the agency develops criteria defining short inpatient stays. “The AHA strongly supports this important legislation,” said Rick Pollack, AHA executive vice president. “The current CMS policy is bad news for seniors because it undermines the medical judgment of physicians. The bill also rightly calls on the agency to develop an acceptable long-term payment solution.” CMS recently delayed enforcement of the two-midnight policy, under which hospital admissions spanning less than two midnights will generally be considered outpatient cases, regardless of clinical severity, until Oct. 1, 2014. However, the agency continues to allow contractors to deny limited numbers of inpatient claims based on prepayment audits under the policy.