One of the changes in the 2014Medicare proposed prospective payment regulations is the two-midnight rule. This rule requires that inpatients must remain in the hospital over two midnights in order to qualify for inpatient reimbursement. Any stay shorter is considered outpatient, which has a much lower reimbursement rate. Fortunately these rules have been delayed until September 30, 2014, but it’s important that you stay on top of this. It could have severe financial ramifications for you or your aging parent.
Hospital leaders have vigorously opposed the two-midnight rule during the past year, arguing that the policy is unclear and undermines the medical judgment of physicians. The Centers for Medicare and Medicaid Services (CMS) introduced the policy to better monitor Medicare payment of short inpatient stays and ensure inpatient admissions are medically necessary. But the fact remains that this is yet another unintended (or intended?) consequence of Obamacare that will affect care for the elderly.