Case Management

Data shows 2-midnight rule compliance lacking

Case Management Insider, September 29, 2015

While there aren’t isn’t a lot of information available on compliance with the 2-midnight rule, the data that is out there isn’t good, according to Steven Greenspan, JD, LLM, vice president of regulatory affairs at Executive Health Resources (EHR) in Newtown Square, Pennsylvania, and Kurt Hopfensperger, MD, JD, vice president of compliance and physician education for EHR. The two spoke about this topic during the HCPro webcast “Medical Necessity Documentation and Short Stays.”

Denial rates reported by Medicare Administrative Contractors range anywhere from a 33% denial rate at First Coast Service Options to 71% reported by Palmetto for its North Carolina hospitals. So if you’re like many hospitals, you’ve probably got more work to do to get your program in line with expectations.

For more information on how to comply check out the November issue of Case Management Monthly.

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