Two-Midnight Provision: Hospital Admission Rule Change Impacts Physicians

December 10, 2013

A new Centers for Medicare and Medicaid Services (CMS) rule known as the “two-midnight provision” instructs physicians on when hospital admission is appropriate.

A new Centers for Medicare and Medicaid Services (CMS) rule known as the “two-midnight provision” instructs physicians on when hospital admission is appropriate.

The rule says that if a physician believes a patient will be in the hospital for at least two or more midnights, CMS expects the patient to be admitted as an inpatient, according to AAFP News Now. Hospital admissions for less time than that may be reviewed by CMS.

 This rule, which is currently in effect, impacts physicians with hospital admitting privileges. It does not directly impact physicians’ payment, but the American Academy of Family Physicians (AAFP) expects physicians will be hearing about this rule because it does affect a hospital’s bottom line.

“I expect hospitals will be putting equal pressure on physicians, including family physicians,  to help them meet the new Medicare standard,” says Kent Moore, AAFP senior strategist for physician payment.