CMS Extends Two-Midnight Partial Enforcement Delay

February 5, 2014
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Rick Gawenda
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On January 31, 2014, The Centers for Medicare & Medicaid Services extended for six months the partial enforcement delay of its two-midnight policy for inpatient admission and medical review criteria. Under the extension, recovery auditors and other Medicare review contractors will not conduct post-payment patient status reviews of inpatient hospital claims with dates of admission on or after Oct. 1, 2013 through Sept. 30, 2014. However, Medicare Administrative Contractors will continue to conduct pre-payment “probe and educate” audits on select claims for patients admitted between Oct. 1, 2013 and Sept. 30, 2014. For more on the claims review policy, see CMS’ updated guidance.


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