TY - JOUR
T1 - Changes to inpatient versus outpatient hospitalization
T2 - Medicare's 2-midnight rule
AU - Locke, Charles
AU - Sheehy, Ann M.
AU - Deutschendorf, Amy
AU - Mackowiak, Stephanie
AU - Flansbaum, Bradley E.
AU - Petty, Brent
N1 - Publisher Copyright:
© 2014 Society of Hospital Medicine.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Outpatient versus inpatient status determinations for hospitalized patients impact how hospitals bill Medicare for hospital services. Medicare policies related to status determinations and the Recovery Audit Contractor (RAC) program charged with postpayment review of such determinations are of increasing concern to hospitals and physicians. We present an overview and discussion of these policies, including the recent 2-midnight rule, the effect on status determinations by the RAC program, and other recent and pertinent legislative and regulatory activity. Finally, we discuss the future direction of Medicare status determination policies and the RAC program, so that physicians and other healthcare providers caring for hospitalized Medicare beneficiaries may better understand these important and dynamic topics.
AB - Outpatient versus inpatient status determinations for hospitalized patients impact how hospitals bill Medicare for hospital services. Medicare policies related to status determinations and the Recovery Audit Contractor (RAC) program charged with postpayment review of such determinations are of increasing concern to hospitals and physicians. We present an overview and discussion of these policies, including the recent 2-midnight rule, the effect on status determinations by the RAC program, and other recent and pertinent legislative and regulatory activity. Finally, we discuss the future direction of Medicare status determination policies and the RAC program, so that physicians and other healthcare providers caring for hospitalized Medicare beneficiaries may better understand these important and dynamic topics.
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U2 - 10.1002/jhm.2312
DO - 10.1002/jhm.2312
M3 - Review article
C2 - 25557865
AN - SCOPUS:84923785404
SN - 1553-5592
VL - 10
SP - 194
EP - 201
JO - Journal of Hospital Medicine
JF - Journal of Hospital Medicine
IS - 3
ER -