Dive Brief:
- On December 1, CMS published a notice with comment period outlining the decision to reduce hospital inpatient payments under the controversial “two-midnight” rule by 0.2%.
- The rule, finalized in November, requires hospital stays to be billed as admissions rather than observation stays.
- The notice, according to Becker’s Hospital Review, is in response to a court ruling where HHS was asked to provide further justification for the pay cut and to fix the notice and comment issues.
Dive Insight:
As previously reported in Healthcare Dive, the rule could reduce average reimbursement per case between $3,000 and $4,000.
The notice stated the agency is not “proposing…to reconsider the 0.2% reduction…However, we are seeking comment on whether we should await the completion of the actuaries’ analysis of FY 2014 and FY 2015 data before resolution of this proceeding.”
"We do not believe this cut was or can be justified," Lawrence Hughes, American Hospital Association assistant general counsel was quoted in Becker’s, adding the organization will “submit a robust critique to CMS as part of the comment process."
Michael Clark, special counsel with Duane Morris, was quoted in Modern Healthcare noting the notice’s content doesn’t fare well for hospitals as “the justification in the notice is likely [to] satisfy the judge who order it.”
Comments will be taken until February 2, 2016. The agency stated it plans to issue a final notice on the payment cut by March 18, 2016.