According to a just-released inpatient payment proposal for 2016, the Centers for Medicare and Medicaid Services plans to gather more feedback on the “two-midnight rule” before changing the controversial measure of inpatient vs. outpatient stays.
“We note that hospitals and physicians continue to voice their concern with parts of the 2-midnight rule … Therefore, we are considering this feedback carefully,” the CMS stated in the report.
[Also: Two-midnight rule delayed until September in SGR repeal bill]
Comments will be taken through June 16, according to the 1,526-page report.
The “two midnight” rule establishes 48 hours as the threshold for classifying a patient stay as inpatient. It was originally supposed to take effect in October 2013 but was first delayed to September 2014 and again postponed until the end of March 2015 in last year’s “doc fix” to the sustainable growth rate formula.
This month Congress passed, and the president signed, passage of a permanent SGR repeal, which pushes back the “two-midnight” rule another six months.
[Also: Two-midnight rule targeted by GOP lawmakers wanting Medicare overhaul]
CMS said it expects to include further discussion of the issue in the 2016 prospective payment systems proposal to be published this summer.
The CMS is expected to issue a final rule by Aug. 1.
In two lawsuits filed last year, the American Hospital Association blasted the two-midnight rule as undermining medical judgment, disregarding the level of care needed to treat patients, burdening hospitals with arbitrary standards and documentation, and depriving hospitals of proper Medicare reimbursement.
Decisions are still pending.
Twitter: @SusanMorseHFN