HCPro, JustCoding Inpatient - 2015 Issue 47 (December)
Healthcare News: CMS invites comments on 2-midnight rule payment calculation
December 16th, 2015
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Article Overview
This article explains a CMS notice responding to a court ruling that required the agency to explain its inpatient payment reduction calculation tied to the 2-midnight rule and to allow stakeholder comment. It is relevant to hospitals, coders, and reimbursement professionals who track Medicare payment methodology, because it summarizes the types of claims data CMS reviewed, the broad payment impact it estimated, and the public comment process associated with the notice.
Why This Topic Matters
The article matters because it discusses a Medicare payment methodology issue affecting inpatient reimbursement and the process CMS is using to justify and revisit its calculation. Readers following hospital billing policy, Medicare inpatient payment changes, or regulatory comment opportunities will want to know the scope of CMS’s analysis and the timeline for submitting input.
What You Will Learn
- How CMS responded to a court requirement involving its payment calculation for the 2-midnight rule
- What general categories of claims data CMS used in estimating the payment impact
- Why the notice and comment period is relevant to Medicare inpatient reimbursement policy
- How the article frames the potential shift in cases between outpatient and inpatient settings
Who Should Read This
- Hospital coders
- Reimbursement specialists
- Revenue cycle professionals
- Medicare compliance teams
- Healthcare administrators
- Policy analysts
Codes Discussed
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