title: IPPS doesn't change two-midnight rule.
abstract: Although the Centers for Medicare & Medicaid Services (CMS) asked for suggestions on alternative methods of identifying and paying for short hospital stays, the agency did not clarify the two-midnight rule in the Inpatient Prospective Payment System final rule for 2015. CMS may issue sub-regulatory guidance to clarify the two-midnight rule later this year or early next year. Hospitals need to stay on top of CMS messages to avoid being blindsided by new rules. Meanwhile, the Medicare Administrative Contractors (MACs) are continuing Probe and Educate audits, and some have denial rates of 75%. Most of the claims were denied because of lack of medical necessity, lack of a physician signature, or because physicians did not document an expected length of stay.
mesh_terms: D019090:Case Management; D014487:Centers for Medicare and Medicaid Services, U.S.; D004469:Economics, Hospital; D033161:Government Regulation; D007297:Inpatients; D016344:Medicare Part A / Q000191:economics; D012051:Reimbursement Mechanisms; D014481:United States