- The Centers for Medicare and Medicaid Services in a proposed payment rule posted Wednesday will ease requirements for the controversial "two-midnight" rule governing inpatient admissions.
- The new rule will allow physicians to use their judgment on a case-by-case basis when admitting patients for short hospital stays.
- The agency also said it will remove oversight of admittance decisions from its administrative contractors, instead asking quality improvement agencies to enforce the rule. RACs will be directed to concentrate only on facilities with unusually high claim denial rates.
Providers and policy experts alike have been calling for the repeal of the two-midnight rule in its entirety—the Medicare Payment Advisory Commission suggested last month that lawmakers make that move—but CMS is standing firm in its support of the policy. The agency said Tuesday that it hasn't received any viable alternatives to the rule, despite three separate requests for public comment.
Under the proposed rule, if a physician admits a patient for an expected short stay, he or she must document evidence supporting the decision, including symptom severity and the risk of an adverse medical event while the patient is hospitalized.