The Centers for Medicare & Medicaid Services has extended the partial enforcement delay of its controversial “two-midnight” rule, which was set to expire on Sept. 30. The delay will now last until Dec. 31.
The Medicare policy requires patients to be hospitalized for two midnights before they qualify as an inpatient, which can allow beneficiaries to qualify for skilled nursing coverage.
With the extension, Recovery Audit Contractors cannot conduct post-payment reviews for claims with dates of admission from Oct. 1 through Dec. 31.Quality Improvement Organizations will conduct patient status reviews to determine whether inpatient status is appropriate during that time period. Starting on Jan. 1, the initial status reviews will be handled by QIOs, with Recovery Auditor Contractors conducting follow up reviews upon referral by QIOs.