Tag Archives: 2 midnight rule

Two Midnight rule helped slash improper payments for inpatient hospital claims by 58 percent, CMS says

said the overall Medicare fee-for-service improper payment rate dropped from 12.1 percent in 2015 to 11.0 percent in 2016. Moreover, improper payments for inpatient hospital claims alone dipped by 58.3 percent, from 9.2 percent in 2014 to 3.8 percent in 2 Continue reading

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CMS Delays JW Modifier and Tells QIOs to Re-Review Denials

A representative of CMS stated that the July 1 2016 deadline for required use of the JW Modifier to report drug wastage is being moved to January 1 2017, on an Open Door Forum Conference Call, today. A transmittal is forthcoming to confirm the change, they also stated. Continue reading

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CMS Keeps But “Adjusts” Two-Midnight Rule

CMS proposes that physicians be allowed to make case-by-case exceptions to the rule, classifying certain short stays as inpatient for reimbursement under Medicare Part A. Continue reading

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Senate Aging Committee Tackles Hospital ‘Observation Status’ Crisis

Senators Question CMS Actions and Logic, Call for Simplicity The U.S. Senate Committee on Aging held a hearing with two panels on Wednesday, May 20, considering the causes and possible solutions to the increased use of Observation services in hospitals, … Continue reading

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“Finally Friday!” How Rounding Can Make a Physician Advisor a Change Agent

Rounding: Making the Physician Advisor an Agent of Change in a Hospital Drs. Howard Stein and Michael Salvatore Plus Yet More Scenarios from Dr. Pahuja At the recent PAUR Boot Camp in Chicago, I once again sat and listened to … Continue reading

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News & Opinion from the Week of November 3 – 9, 2013

AHA and AMA to CMS Re: Two-midnight Policy Inpatient Admission and Review Criteria The AHA and the AMA issued a joint letter to CMS Administrator Marilyn Tavenner on Friday, January 8, in a rare show of combined agreement and support … Continue reading

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