The Controversial “Two-Midnight” Rule: Where We’ve Been And What To Expect When Implementation Begins Later This Year

On April 16, 2015, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law. Among other functions,1 MACRA further delayed the implementation of the much-anticipated provisions of the 2014 Inpatient Prospective Payment System Final Rule affecting reviews of inpatient admissions, including new guidelines for inpatient admissions known as the “two-midnight” rule, until October 1, 2015. Despite the continued implementation delay and CMS’s efforts to educate providers on significant changes to inpatient billing regulations contained in the new rule, substantial uncertainty remains, both as to the long-term effect on providers as well as the possibility of future changes to Medicare regulations governing inpatient admissions and the Recovery Audit program. Despite this uncertainty about the future of the Medicare Part A regulatory landscape, there are affirmative steps that providers can take which will ameliorate the anticipated impact of the 2014 Inpatient Final Rule when it finally becomes effective for inpatient admissions.  The complete article authored by Jennifer Gross and Briar Siljander appeared in the April 2015 issue of the American Bar Association’s Health eSource publication, and is available on the American Bar Association website at: http://www.americanbar.org/publications/aba_health_esource/2014-2015/april/controversial.html.