February 3, 2014—The Centers for Medicare and Medicaid Services (CMS) is once again delaying enforcement of its new “two-midnight rule” for deciding whether a patient is an inpatient for Medicare billing purposes. [ms-protect-content id=”2799″]
Under the rule, hospitals can bill Medicare for procedures, tests, and other treatments on an inpatient basis only when the patient’s stay has spanned two midnights. CMS originally planned to begin enforcing the rule on Oct. 1, 2013 but pushed the date back to March 31 due to complaints from hospitals and physicians. On Jan. 31, it pushed the enforcement date back again, until after Sept. 30.
A hospital patient’s admission status has significant implications for 340B drug discount purposes. Drugs purchased at the 340B-discounted price may be administered or dispensed to outpatients only. [/ms-protect-content]