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Public Policy Updates

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Medicare revises policies about therapy services coverage

Posted on: 4/7/2014

Following the settlement to a class-action lawsuit filed against Kathleen Sebelius, Medicare notified health care providers that beneficiaries cannot be discontinued from therapy services if their condition does not improve... View Full Posting

Senate Approves SGR Patch, Delays Implementation of ICD-10

Posted on: 4/1/2014

The Senate yesterday approved a temporary patch to the sustainable growth rate (SGR) payment formula that will prevent significant Medicare payment cuts for another year and also delays the implementation of ICD-10 to at least October 2015... View Full Posting

CMS Releases FY 2012 Report on RAC Program

Posted on: 3/31/2014

According to a report by the Centers for Medicare and Medicaid (CMS), recovery audit contractors (RACs) denied $2.4 billion in payments to Medicare providers in fiscal year 2012, and more than 90% of the denials were for inpatient services... View Full Posting

House Votes to Approve Temporary SGR Fix

Posted on: 3/27/2014

The U.S. House of Representatives today approved a temporary fix to the sustainable growth rate (SGR) for one year... View Full Posting

Report Finds 'Two-Midnight' Rule Negatively Impacts Hospital Volumes, Earnings

Posted on: 3/19/2014

A recent report from Moody's Investor Service predicts that the "two-midnight" rule will negatively impact hospital earnings... View Full Posting

CMS Updates Two-Midnight Guidelines

Posted on: 3/17/2014

On March 12th, the Centers for Medicare and Medicaid Services (CMS) updated its "Reviewing Hospital Claims for Patient Status: Admissions On or After October 1, 2013" and frequently asked questions for "2 Midnight Inpatient Admission Guidance and Patient Status Reviews for Admissions on or after October 1, 2013"... View Full Posting

Researchers Study the Clinical Impact of the Two-Midnight Rule

Posted on: 3/12/2014

The Journal of Hospital Medicine recently published a study on the clinical impact of the two-midnight rule on observation and inpatient status... View Full Posting

Providers Hope CMS Rescinds Two-Midnight Rule

Posted on: 3/12/2014

The most recent two-midnight rule guidance (released Feb. 24) by the Centers for Medicare and Medicaid Services (CMS) has been praised by the American Hospital Association (AHA) for providing "welcomed clarification"; however, the AHA still considers the policy "fundamentally flawed"... View Full Posting

NBC Nightly News Suggests Observation Status is an Arbitrary Decision

Posted on: 3/5/2014

Last month NBC Nightly News aired a segment to warn Medicare beneficiaries of the higher prices they could pay when they are placed under observation in the hospital. The reporter interviewed a Harvard professor of public health who implies that many patients are arbitrarily placed under observation for the financial benefit of the hospital... View Full Posting

CMS Releases New Requirements for MAC "Probe and Educate" Audits

Posted on: 2/26/2014

Monday the Centers for Medicare and Medicaid Services (CMS) released additional information on the two-midnight rule “probe and educate” audits... View Full Posting