The Centers for Medicare & Medicaid Services has updated a handful of documents in the past week on the controversial regulations surrounding its two-midnight inpatient admissions guidance and patient status reviews.
The documents include a Frequently Asked Questions fact sheet about the two-midnight policy for hospital inpatient medical review and admissions criteria, as well as a guidance document on Selecting Hospital Claims for Patient Status Reviews. A CMS document also relevant to the two-midnight rule, Reviewing Hospital Claims for Patient Status, was updated last Friday.
The documents were updated in response to questions received from the hospital industry and verbally reviewed by CMS at its Sept. 26 Open Door Forum.
The CMS documents clarify that it will not conduct post-payment patient status reviews for claims with dates of admission Oct. 1, 2013 through March 31, 2014, three months longer than previously announced. The Selecting Hospital Claims for Patient Status Reviews document also offers additional details on the “probe and educate” audits that will be conducted by Medicare Administrative Contractors.
The American Hospital Association has commented that CMS policy on post-payment status reviews, as explained in the documents, still "lacks clarity and certain parts appear to be inconsistent with guidance previously issued by the agency."