CMS has announced that it is extending provider education activities related to its new Medicare inpatient hospital admission and medical review criteria (commonly known as the 2-Midnight Rule). Specifically, CMS is extending what it refers to as the “Probe & Educate” review process for an additional six months, through September 30, 2014. Under this extension, Recovery Audit Contractors (RACs) and other Medicare review contractors will not conduct post-payment patient status reviews of inpatient hospital claims with dates of admission on or after October 1, 2013 through October 1, 2014. Medicare Administrative Contractors (MACs) will continue to select claims for review with dates of admission between March 31, 2014 and September 30, 2014, however, and claims not in compliance will be denied. MACs also will continue to hold educational sessions with hospitals through September. CMS also has clarified related provisions regarding physician orders for and certification of hospital inpatient services.
Home Other Health Policy Developments Other CMS Developments CMS Again Extends “Probe & Educate” Phase for 2-Midnight Inpatient Admissions Criteria Implementation; Clarifies Physician Certification Requirements