Monitor Mondays

Does the Two-Midnight Rule Apply to MA Plans?

October 02, 2023 Dennis R. Jones Senior Director | Cate Brantley, JD | Knicole Emanuel, Esq | David Glaser, Esq | Ronald Hirsch, MD Season 13 Episode 563
Monitor Mondays
Does the Two-Midnight Rule Apply to MA Plans?
Show Notes Chapter Markers

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.