Two-Midnight Rule

News & Analysis as of

One Last Shot at Meeting October Deadline on Two-Midnight Appeals

On October 27, 2014, the Centers for Medicare & Medicaid Services (CMS) made a concession—a very small one—to hospitals racing against the looming October 31, 2014, deadline for accepting the offer of 68 cents on the dollar...more

Critical Access Hospital Soothsayers and the 96-Hour Physician Certification Requirement

This year critical access hospitals (CAH) have struggled to implement procedures to comply with both the "two-midnight" rule and the 96-hour physician certification requirement. The combination of both puts physicians in a...more

Attention Hospitals! Act Now To Get 68 Cents For Your Medicare Dollar!

It’s no secret that CMS is drowning in appeals from denials of Medicare claims for inpatient care. The number of pending appeals was estimated at half a million back in February, and it’s only grown since then. One reason...more

Highlights from the Senate Special Committee on Aging’s Hearing on Medicare Observation Status

A recent Senate Special Committee on Aging hearing focused on the impact of Medicare observation status, a hospital outpatient designation for which Medicare covers fewer services and generally reimburses for services at a...more

The Probe and Educate Process For The Two-Midnight Rule

On August 2, 2013, the Centers for Medicare and Medicaid Services (“CMS”) released the final rule for the 2014 Medicare Inpatient Prospective Payment System (“IPPS”), effective October 1, 2013.[1] Introduced in the IPPS...more

Medicare Patients Caught In Two-Midnight Rule Crossfire

Hospitals have been complaining about the two-midnight rule since it was first announced. But mounting evidence indicates that Medicare patients themselves are suffering badly from the effects of the rule....more

Newly Released CMS Actuary’s Report Confirms CMS Ignored Impact of Two Midnight Rule on Medical Admissions When Setting 0.2...

On June 30, 2014, King & Spalding filed comments in response to Medicare’s proposed IPPS rule for Fiscal Year (FY) 2015 on behalf of more than 200 hospitals it represents in a federal court challenge to the FY 2014 Two...more

CMS Joins In Bashing The Two-Midnight Rule

Hospitals hate it. Doctors hate it. Congress hates it so much it required CMS to delay audits of compliance until next year. Then yesterday CMS Deputy Administrator Sean Cavanaugh, testifying before a House Committee...more

House Ways and Means Health Subcommittee to Hold Hearing on Medicare Issues

On May 13, 2014, House Ways and Means Health Subcommittee Chairman Kevin Brady (R-TX) announced that the Subcommittee will hold a hearing on hospital issues facing Medicare providers, with an emphasis on the "Two-Midnight...more

AHA Challenges to the Two-Midnight Rule - Preserve Your Hospital's Right to Challenge

The American Hospital Association (AHA), along with several state and regional hospital associations and several hospitals, recently filed two lawsuits challenging CMS’s two-midnight rule and related policies....more

King & Spalding Files Court Challenge to 0.2 Percent IPPS Rate Reduction

On March 25, 2014, King & Spalding filed a complaint in the United States District Court for the District of Columbia challenging CMS’s 0.2 percent reduction to FY 2014 IPPS payment rates associated with the two-midnight...more

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