For most services, Medicare B reimburses providers at 80 percent of the Medicare A rate. Friday's announcement from CMS is the third time since October that full implementation of the two-midnight rule has been delayed.
CMS officials have said the rule is needed to clarify admission guidelines and address a recent spike in Medicare patients being admitted to hospitals for brief observation stays. Objections from hospitals and doctors have included unease over the financial impact of the rule on patients, who face higher copays, and concern that the rule will penalize efficient treatment of patients in less than two nights.
Prater says Gerlach introduced a bill in December that sought to force CMS to delay the full rollout of the two-midnight rule until the beginning of the next federal fiscal year in October. "That was really the main part of the bill," Prater said of the legislation, which had 85 co-sponsors when CMS embraced the delay on Friday. "It gave hospitals an opportunity to come in and make their case with their representatives."
In a prepared statement issued Monday, the American Hospital Association sounded a guardedly optimistic tone on the latest two midnight rule delay.