tci Medicare Compliance & Reimbursement - 2017 Issue 23
Industry Notes: Two-Midnight Rule Court Case Adjusts Some Hospitals' Medicare Pay
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Article Overview
This article explains a CMS update about a court case and settlement related to the Two-Midnight rule and how it affects Medicare hospital payment adjustments. It is relevant to hospital revenue cycle teams, inpatient billing staff, and coders who monitor Medicare transmittals, Change Requests, and IPPS-related payment guidance. The piece focuses on the policy background, the timing of the adjustment, and the hospitals and dates referenced in CMS instructions.
Why This Topic Matters
Hospitals that participate in Medicare need to track CMS transmittals and change requests that can alter payment calculations for specific discharges and time periods. This update helps affected organizations understand that a retroactive payment-related adjustment is being implemented under CMS guidance.
What You Will Learn
- The CMS policy issue addressed by the update
- How a court case and settlement relate to Medicare payment adjustments
- Which CMS guidance documents and implementation dates are referenced
- Which hospitals and discharge periods are affected by the update
Who Should Read This
- Hospital coders
- Inpatient reimbursement specialists
- Revenue cycle teams
- Medicare billing staff
- Compliance staff
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