Senate bill would revamp 2-midnight rule for hospital inpatient admissions

Share this article:

Providers' complaints about the so-called “two-midnight rule” for determining hospital inpatient status have led to a new bipartisan bill in the U.S. Senate, which would create less rigid guidelines.

Sens. Robert Menendez (D-NJ) and Deb Fischer (R-NE) introduced the “Two-Midnight Rule Coordination and Improvement Act of 2014” on Wednesday. The measure would revise a final rule implemented by the Centers for Medicare & Medicaid Services in August, which calls for Medicare beneficiaries to be given inpatient status after they are in the hospital for longer than two midnights.

The rule was intended to address the growing problem of observation status. Hospitals increasingly are placing patients in this outpatient category even if their stays last several days. By doing so, hospitals can avoid the financial repercussions of having auditors determine that inpatient status was granted unnecessarily. However, seniors kept in observation status do not meet the minimum inpatient threshold to qualify for follow-up skilled nursing care, so they can be saddled with enormous out-of-pocket expenses.

Hospitals and physicians blasted the two-midnight rule, saying they need the freedom to place patients in the category that will allow them to receive the most appropriate care.

The Senate bill would establish “criteria and payment methodologies” to ensure that short inpatient hospital stays are viable if the medical necessity exists. It also would “codify” current auditing freezes that CMS has put in place as the current regulation is implemented, according to a news release from Menendez and Fisher.

The American Hospital Association and the Association of American Medical Colleges said they supported the bill.

Share this article:

More in News

Genesis, Skilled Healthcare merger to create huge long-term care provider with more than 500 facilities

Genesis, Skilled Healthcare merger to create huge long-term ...

Genesis HealthCare and Skilled Healthcare Group Inc. will merge to create a single long-term and post-acute care company with more than 500 facilities nationwide, the providers announced Tuesday.

Antipsychotic use tied to acute kidney injury, increasing pressure on nursing home ...

Older people who take antipsychotic medications are at a markedly increased risk of acute kidney injury, according to newly published research findings out of Canada. The study further supports ongoing efforts to reduce the number of nursing home residents on these drugs.

Family alleges long-term care facility banned them due to social media posts, ...

Family members of a Texas long-term care resident have sued the facility where she lives, claiming they were banned from visiting due to their social media posts, according to a publication covering legal proceedings in the state.