tci Medicare Compliance & Reimbursement - 2015 Issue 22

Quality of Care: Brace Yourself for New Scrutiny of Your 'Two-Midnight Rule' Compliance

What you should do before submitting claims to reduce your risk. The Centers for Medicare & Medicaid Services (CMS) is changing the way its review contractors investigate hospitals’ short-stay claims. Those changes are in your favor, but that doesn’t mean you can let your guard down. Beware: New QIO Limitations Don’t Extend to Other Contractors Medicare’s “Two-Midnight Rule” has postponed the date when quality improvement organizations (QIOs) will take over for recovery audit contractors (RACs) in reviewing short inpatient hospital stay claims until Jan. 1, 2016. This date is more than two months later than...

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