Does the Two-Midnight Rule Apply to MA Plans?

Monitor Mondays

The Centers for Medicare & Medicaid Services (CMS) is on record saying that Medicare Advantage (MA) payers must follow the Two-Midnight Rule as of Jan. 1, 2024. Yet, it has been reported by multiple hospitals that their MA plans have said their lawyers tell them that they do not have to follow the CMS directions on the Rule relative to inpatient status, claiming their contracts govern their relationships and coverage issues with hospitals.

During the next live edition of Monitor Mondays, Dennis Jones, senior director of revenue cycle (a single business office) for Jefferson Health, will report on the arguments that seem to be iginiting a firestorm on the Internet.

Broadcast segments will include these instantly recognizable features:

• Monday Rounds: Dr. Ronald Hirsch, vice president of R1 RCM, will make his Monday Rounds.

• The RAC Report: Healthcare attorney Knicole Emanuel will report the latest news about auditors.

• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

• Legislative Update: Cate Brantley, state legislative analyst for Zelis, will report on the latest legislative actions impacting the healthcare regulatory setting.

Capitole

1. Does the Two-Midnight Rule Apply to MA Plans? (00:00:00)

2. Ronald Hirsch, MD (00:01:30)

3. Knicole Emanuel, Esq (00:05:38)

4. ACPA Commercial (00:11:11)

5. David Glaser, Esq (00:12:29)

6. Cate Brantley, JD (00:17:29)

7. RACmontior Commercial (00:21:36)

8. Dennis R. Jones Senior Director (00:22:49)

9. Closing (00:28:32)