House Lawmakers Ask CMS to Delay "Midnights" Stay Provision
Monday, October 14, 2013
by: VNAA Policy Team

Section: Public Policy and Advocacy

In a letter to the Centers for Medicare and Medicaid Services, more than 100 bipartisan House lawmakers asked  for a six-month delay in a provision in a Medicare hospital rule governing patient “observation” status.  The American Hospital Association is calling for a delay of at least three months in the policy.

The final rule issued Aug. 2 went into effect Oct. 1.  Under the new policy, if a physician expects a beneficiary's treatment to require a two-night hospital stay and admits the patient under that assumption, Medicare Part A covers the patient’s stay.  Accordingly, the policy presumes that stays spanning less than “two midnights” are on an outpatient basis under Medicare Part B, which might result in higher copayments for the beneficiary.

The House letter, spearheaded by Rep. Allyson Y. Schwartz (D-Pa.,) states that hospitals and health systems nationwide expressed serious concerns about the timetable for implementations and the practical implications the new policy has on health-care providers and Medicare beneficiaries.  Lawmakers also note that the “two midnights” provision in the fiscal 2014 final inpatient hospital rule issued by the CMS in August would cause beneficiaries to face higher out-of-pocket costs for their care.

No further decision has been made on this issue due to the government shut down.  
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