Medicare two-midnight rule

Insurers Skirting Medicare Two-Midnight Rule?

Health care payers continue to classify large numbers of Medicare admissions as “observation status,” and while the recent extension of the two-midnight rule to Medicare Advantage plans has resulted in a decline in the use of observation status classifications among those plans, Medicare Advantage plans still use the observation status classification more than three times as often as traditional Medicare. According to a new study, Medicare Advantage plans used the observation rate classification for between 14.4 percent and 16.1 percent of their claims during the first half of 2024.  Traditional Medicare?  With a one-month exception, from 3.7 percent to 5.2 [...]

2024-10-30T11:41:07-04:00October 30, 2024|hospitals, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for June 20

The following is the latest health policy news from the federal government for June 14-20.  Some of the language used below is taken directly from government documents. No Surprises Act HHS and the departments of Labor and the Treasury have announced a policy that offers extra time to health care providers whose desire to engage in No Surprises Act adjudication of payment disagreements with payers was affected by the Change Healthcare cybersecurity attack.  Under this temporary policy,  providers, facilities, and providers of air ambulance services whose ability to initiate timely No Surprises Act open negotiation for any item or service [...]

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