Tag Archives: 2mn 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 issues more details on pause of QIO two-midnight review

CMS has provided additional information on its temporary pause of BFCC-QIO claim audits under the two-midnight inpatient admissions policy. CMS anticipates that QIOs will resume audit activities within 60-90 days. Continue reading

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CMS Temporarily Pauses Two-Midnight Reviews by QIOs

Reasoning Unclear, Time-frame Indeterminate Audits of Medicare claims concerning the Two-Midnight Rule are temporarily suspended by CMS, to allow CMS to collaborate with the two BFCC-QIO contractors, Livanta and KEPRO, “to ensure consistency in how the rule is applied to … 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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SGR Fix Extends Moratorium on 2-Midnight Rule Enforcement

H.R.2 Restricts RAC Reviews of Patient Status Through September Passage of the bill H.R. 2 Medicare Access and CHIP Reauthorization Act (MACRA) last night by the U.S. Senate extended many programs, including a slight extension of the Medicare Administration Contractors … Continue reading

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