Case Management

CMS puts short-stay audits on hold

Case Management Monthly, August 1, 2016

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Case Management Monthly.

There's good news and bad news on the 2-midnight rule front.

The good news: CMS has put short-stay inpatient audits related to the 2-midnight rule on hold as of May 4.

The bad news: This isn't a free pass, and it isn't going to last.

"Response at hospitals should be to do nothing different," says Ronald Hirsch, MD, FACP, CHCQM, vice president of the Regulations and Education Group at Accretive Physician Advisory Services at Accretive Health in Chicago. "Follow the rules on every case. This is not a three-year delay; the audits will resume soon, and we have no idea if the look-back period will be altered to account for this delay."

Livanta, one of the two Beneficiary and Family Centered Care Quality Improvement Organizations (BFCC-QIO) charged with conducting 2-midnight rule compliance audits, posted a notification about the audit suspension on its website: http://bfccqioarea5.com/twomidnight.html. The announcement stated:

On May 4, 2016, CMS notified the BFCC-QIOs of a temporary pause of Two-Midnight Reviews in order to improve standardization across the program. During this period, Livanta will be collaborating with CMS and the other BFCC-QIO to ensure consistency in how the rule is applied to QIO case review. If your facility has submitted Livanta requested medical records, they will remain in the pipeline for review upon further direction from CMS. Going forward it is CMS' intention that providers will have at least six weeks to implement changes prior to the next round of BFCC-QIO reviews. 

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Case Management Monthly.

Most Popular