Reed Seeks Clarification on Cms Rule for Hospitals, Patients
Rep. Tom Reed says he’s pleased the Centers for Medicare and Medicaid Services (CMS) announced it will extend review of its two-midnight policy through September 30, 2014, giving CMS and local hospitals time to find a long-term solution to ensure a responsible payment mechanism is in place for shorter inpatient stays in hospitals.
“The CMS announcement is welcome news for hospitals looking for clarification and guidance on the two-midnight policy,” Reed said. “The delay will allow CMS to work with local stakeholders on fair policy for shorter hospital stays and finalize better policy to care for patients. While this announcement is a good first step we still have work ahead of us to fix this problem on a long-term basis. Our local hospitals have been strong partners in our push for common-sense, workable legislation and we’ll continue to build on those relationships to see good, sound policy implemented.”
The two-midnight policy was introduced last fall by CMS in the FY2014 Hospital Inpatient Prospective Payment System and would place restrictive parameters on reimbursements under Medicare Part A to hospitals for inpatient stays that last less than two-midnights, regardless of whether a physician determines that intensive services are required based on patient symptoms. The original announcement did not give hospitals ample time to adjust to the new rules.
The announcement that CMS will extend its review came as a result of bipartisan legislation Reed introduced in December with fellow New York Rep. Joe Crowley (D) and Rep. Jim Gerlach (R-PA). The Two-Midnight Rule Delay Act of 2013 postpones the CMS policy, giving CMS more time to find a long-term solution that reduces financial and logistical consequences for hospitals. Rep. Reed has been working with stakeholders including the Healthcare Association of New York State, the Greater New York Hospital Association and the American Hospital Association on this legislation.
"Congressman Reed's leadership on this issue has resulted in a common-sense approach to a very complex situation," said Robert K. Lambert, M.D., President and CEO of Arnot Health. "A delay now will give Arnot Health, and hospitals and systems around the country, time to develop strategies to deal with this rule change, and to ensure we can comply with the requirement while maintaining the level and quality of care to which we remain committed. Further, the concept of a ‘short stay DRG’ under the IPPS is very appealing to us, since it will lower co-pays for our patients, and help mitigate revenue short falls for us."
Dennis Whalen, President of the Healthcare Association of New York State (HANYS), New York's statewide hospital association, said, "Congressmen Gerlach, Crowley and Reed have led the way on pressuring CMS to provide breathing room to hospitals from aspects of the Two Midnight Rule while pressing onward with their bill that would ensure patients' inpatient hospital stays shorter than Two-Midnights could still be paid under the inpatient system, allowing patients all of the benefits of a qualified inpatient stay."
Additionally Kenneth E. Raske, President of The Greater New York Hospital Association (GNYHA) praised the announcement saying, "The Two-Midnight Rule Delay Act of 2013 will help protect New York's hospital community from a deeply misguided policy that will financially harm hospitals and reduce protections and benefits for Medicare patients. Equally important, this legislation would require the Federal government to implement a more sensible payment methodology for short inpatient hospital stays. We applaud Representatives Reed, Crowley and Gerlach for their leadership on this issue."