The Centers for Medicare and Medicaid Services (CMS) issued regulations applicable to Medicare Advantage (MA) plans—also commonly referred to as managed Medicare or Part C Medicare—in April 2023 (CMS ...

The “2-midnight rule” means that for services to be eligible for payment under Medicare Part A, a doctor must state that you will be medically required to stay in a hospital for two midnights. The ...

The Centers for Medicare and Medicaid Services' January expansion of the two-midnight rule to include Medicare Advantage plans has contributed to higher inpatient volumes and revenue growth in the ...

CMS’ expansion of the two-midnight rule led to increased inpatient volumes and revenue growth for some health systems this year, but the jury is still out on its long-term impact on hospital ...

In the 2014 IPPS Final Rule, CMS finalized its proposal to establish that, “For purposes of payment under Medicare Part A, an individual is considered an inpatient of a hospital, including a critical ...

Kodiak Solutions said its analysis of hospital inpatient and outpatient claims data suggests that payers are “continuing to apply their own criteria for inpatient admission and dismissing the ...

CMS estimates that between 2017 and 2021, Medicare Part A improperly paid $23.9 billion for inpatient hospital stays, with $7.8 billion attributable to short stays that did not qualify for Medicare ...

A coalition of health-care systems, led by Novant Health Inc., has agreed to another stay in their lawsuit against the secretary of the U.S. Department of Health and Human Services involving the “two ...

The Centers for Medicare & Medicaid Services is holding a special Open Door Forum conference call at 1 p.m. (Eastern Time) Tuesday to discuss the “two-midnight” hospital inpatient policy. Callers also ...