CMS resumes two-midnight rule audits

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Quality Improvement Organizations have resumed audits of short-stay hospital admissions under the two-midnight rule, the Centers for Medicare & Medicaid Services announced Monday.

The agency temporary halted the audits in May, reportedly due to a need to “improve standardization across the QIO program.” QIOs took on inpatient auditing duties last November.

The QIOs have now successfully completed re-training on the controversial two-midnight policy, which requires patients to be in the hospital for at least two midnights before they qualify as an inpatient, and finished a re-review of hospital stay Medicare claims that were previously denied.

The QIOs have also communicated with healthcare providers whose claims were impacted by the temporary suspension, and initiated provider outreach and education about the two-midnight policy, CMS said.