Corporate Compliance

Patient Status Summer Series?Part Two: Medical Necessity Documentation and Short Stays

Medicare Insider, July 21, 2015

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Medicare regulations surrounding the 2-midnight rule are continually evolving, making it more important than ever for healthcare professionals to stay on top of medical necessity criteria, including projected changes outlined in the 2016 OPPS proposed rule for stays expected to last less than two midnights.

CMS attempted to resolve some of the confusion surrounding medically necessary inpatient admissions when it finalized the 2-midnight presumption and benchmark. However, the rule contains exceptions, and physicians will still need to determine whether a patient meets the medical necessity criteria prior to admission.

During this program, our expert speakers Steven A. Greenspan, JD, LLM, and Kurt Hopfensperger, MD, JD, will review proposals in the 2016 OPPS proposed rule related to inpatient admissions, including the possibility that reviews of the 2-midnight rule could shift from Recovery Auditors to Quality Improvement Organizations. They will also explain the 2-midnight rule, define CMS' guidance on short stays, identify current audit risk areas, and offer tips for determining and documenting medical necessity.

Click here for more information, including learning objectives and agenda, and to register.
 



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