The New Jersey Hospital Association is providing a complimentary webinar to update providers on recent clarifications to the two-midnight rule by the Centers for Medicare and Medicaid Services. The webinar will be held Sept. 21, at 1 p.m.

The two-midnight rule established Medicare payment policy regarding the benchmark criteria that should be used when determining whether inpatient admission is reasonable and payable under Medicare Part A.

CMS temporarily paused the Beneficiary and Family Centered Care (BFCC) Quality Improvement Organizations’ (QIOs) initial patient status reviews this spring to determine the appropriateness of Part A payment for short stay inpatient hospital claims. CMS took this action in an effort to promote consistent application of the medical review of patient status for short hospital stays and to allow time to improve standardization in the BFCC-QIOs’ review process.

Beginning June 6, CMS required the BFCC-QIOs to re-review all short stay patient status claims that were denied under the QIO medical review process since the start of the review process last fall. CMS has announced clarifications to the instructions for medical review of claims affected by the temporary suspension. NJHA successfully filed litigation, along with the American Hospital Association and other hospital plaintiffs, which argued that CMS failed to meet all legal requirements for rulemaking when the agency cut hospitals’ inpatient payments as part of the two-midnight policy.

This webinar is intended to help providers understand the policy changes finalized that pertain to the two-midnight rule and short stay reviews. Participants need to register for this free program.