- Six Ohio hospitals, in hopes to strike a part of the controversial two-midnight rule, is suing the HHS, Modern Healthcare reported.
- The part of the rule in question would reduce inpatient services compensation by 0.2%. A similar September suit from the American Hospital Association also took umbrage with the reduction yet the judge, rather than throwing the rule out with the force of 1,000 winds, asked HHS to provide further justification for the pay cut.
- The rule was finalized this month. CMS did not accept any counterproposals to the two-midnight policy, such as creating a one-midnight rule, or provide more detail on the "physician judgment" exception to the rule.
Being none too pleased at a payment reduction (the hospitals estimate $564,106 will be lost annually under the rule), the six Ohio hospitals allege HHS didn’t properly follow the rulemaking process, Modern Healthcare reported.
In the final rule, CMS disagreed such actions related to the September ruling were necessary and addressed concerns about potential gaming of the hospital admissions process. Among other changes, it notes recovery audit contractors (RACs) will no longer be utilized as first reviewers for short patient claims.
Michael Clark, special counsel at Duane Morris, told Modern Healthcare he is unsure the suit will succeed in striking down the payment reduction but wouldn’t be surprised if the action opened the doors to more suits for HHS from hospitals over the payment reduction.