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SGR Bill Would Extend Delay of 'Two-Midnights' Policy
The House Ways and Means bill to temporarily prevent Medicare physician payment cuts also would deliver an Easter gift to hospitals-a six-month extension to comply with a controversial new inpatient payment rule for hospitals.
The House Ways and Means bill to temporarily prevent Medicare physician payment cuts also would deliver an Easter gift to hospitals—a six-month extension to comply with a controversial new inpatient payment rule for hospitals.
The existing “two-midnights” rule says admitting physicians must have good reason to believe that a patient will need two nights in the hospital before Medicare will pay full inpatient rates under Part A for the stay. Lacking such documentation, Medicare auditors will generally classify the stay as outpatient observation, which pays hospitals much less under Part B and sticks the patient with a 20% copayment. That rule went into effect Oct. 1. But it was modified so that Medicare's aggressive recovery auditing companies could not overturn claims under the new policy until Sept. 30, 2014.
Read the full story here: http://bit.ly/1hwOUIi
Source: Modern Healthcare
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Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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