Federal officials have ordered their auditors to double-check all Medicare inpatient claims that were denied payment under the new "two-midnight" rule since Oct. 1.
The Medicare agency rolled out the rule last fall to clarify precisely when its beneficiaries should receive expensive inpatient treatment paid in full by the government, and when they should be treated through outpatient observation, which pays hospitals less and exposes patients to cost-sharing. Generally the new rule says patients need to be in a hospital bed for two nights, the so-called “two midnights,” to qualify for inpatient care.
But the policy has proven difficult to implement in the nation's roughly 5,000 Medicare-receiving hospitals, and clarifications issued on Sept. 5 and Jan. 30 are raising new complications.
