The Centers for Medicare & Medicaid Services (CMS) clarified some details on the controversial “two-midnight rule,” shortly after its decision to delay the rule until October.
Under the rule, a patient must stay in a hospital for two consecutive midnights before Medicare reimburses the hospital at inpatient rates. In its clarification, made during a Tuesday conference call, CMS officials specified that hospitals must include the admitting physician’s signature before discharge in their documentation of patients admitted under the rule. Even if another clinician who lacked admitting privileges entered the patient’s information, the admitting physician’s signature would be sufficient certification, according to Daniel Schroeder, a member of CMS’ division of acute care.
Hospitals must also include documentation if they discharge an inpatient before the two-midnight threshold due to unforeseen circumstances. Furthermore, if the admitting physician doesn’t sign, hospitals must treat the care as Part B outpatient care – which carries lower payments – when seeking reimbursements.
Click here to read the full text of CMS guidelines.