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CMS Extends Enforcement Moratorium for Two-Midnights Rule

Posted on 8/13/2015 by NTOCC ® in Public Policy Updates

The Centers for Medicare & Medicaid Services announced that it is extending the enforcement moratorium for part of the “two-midnights” rule until the new proposed rule takes effect on January 1, 2016. As you may recall, the “two midnights” rule states that hospital stays that are shorter than two nights would be classified as outpatient. The “two midnights” has been extremely controversial in the NTOCC community, the health care community at large and on Capitol Hill. It creates confusion for the patient and relies on an arbitrary length of time for a patient’s assessment as opposed to the expertise of the health care provider.

Earlier this summer, CMS put forward a policy in the proposed 2016 outpatient pay rule that would relax the two-midnight rule and recognize some hospital stays shorter than two nights as legitimate.  The change would make it easier to get an exception to the rule and is an attempt to satisfy groups who have taken issue with the policy and advocated for it to be withdrawn.

 NTOCC staff is continuing to monitor the situation both at CMS and with possible legislation in Congress.