Health groups ask for Medicare rule delay

Medical trade groups want the Obama administration to delay a change to the way it hands out Medicare dollars.

Two major hospital and physician organizations wrote to the Centers for Medicare and Medicaid Services (CMS) on Friday asking it to push back the implementation of a rule designed to clarify when Medicare pays for inpatient versus outpatient visits.


The so-called “two-midnight policy” says that most patients need to spend at least two days in a hospital to be considered for inpatient care. Stays that are shorter than that will be counted as outpatient visits.

Medicare pays less money for outpatient visits than for inpatient stays. Inpatient trips are covered under Medicare Part A, which pays for hospitals. Outpatient coverage comes from Medicare Part B, which pays for doctors.  

Healthcare groups have opposed the policy.

In their letter on Friday, the American Medical Association and the American Hospital Association said that it ignores how much care patients actually need and undermines doctors’ expertise.

“The fundamentally flawed, overly complicated two-midnight policy does not provide the clarity needed for consistent decision-making by either providers or reviewers,” the groups wrote on Friday.

The policy was originally set to go into effect on Oct. 1, but CMS announced that it would partially delay enforcing the rule until March 31 earlier this year.

The groups want it pushed back to Oct. 1, 2014.

“Providers need additional time to reevaluate and potentially change many internal policies, update existing electronic medical records systems, and alter work flow processes to ensure compliance with the two-midnight policy,” they wrote.

They also say that the agency should hold a meeting with hospital organizations and other health groups to “develop alternate policy solutions” that would consider current trends of patient care.