• Skip to primary navigation
  • Skip to main content
  • 1-800-960-1371
  • Agent Login
  • Quoting Tools
    • Life
    • Senior
  • Free Marketing Guide
  • Blog

AgentLink

With AgentLink, you have easy access to the carriers you want and the tools and resources you need to offer the best to your clients.

  • Products
        • Life
          • Info
          • Products
          • AML Training
          • Quoting Tool
        • Senior
          • Info
          • Products
          • Certifications
          • Compliance
          • Quoting Tool
        • Group Benefits
          • Info
          • Products
          • Our Process
          • Group Enrollment Form
        • Individual Benefits
          • Info
          • Products
          • Our Process
          • Enrollment Tool
        • See our Concierge Services
  • Tools
  • Resources
    • Marketing Guide
    • Carrier Links
    • Group Compliance Resources
    • Sales Webinars
    • Training Webinars
    • Insurance Marketing Webinars
  • About
  • Contact Us
  •  1-800-960-1371
  • Life Quoting Tool
  • Senior Quoting Tool
  • Marketing Guide
  • Blog
Previous
Next

AHA goes after ‘two-midnight’ rule in court

The controversial “two-midnight” rule just got a little more controversial; the American Hospital Association Monday filed two lawsuits against the rule and was joined in its suit by several state hospital associations and individual hospitals.

“The two-midnight rule undermines medical judgment and disregards the level of care needed to safely treat patients,” said Richard Umbdenstock, president and CEO of the AHA, in a release announcing the lawsuits. “Hospitals stand by a physician’s decision on what care is appropriate for each patient. The two-midnight rule is misguided and we feel confident the court will agree.”

The suits were filed against HHS, contending that several provisions of the rule “burden hospitals with unlawful arbitrary standards and documentation requirements and deprive hospitals of proper Medicare reimbursement for caring for patients,” the release stated.

“The hospitals take issue with the wholly arbitrary requirement that a physician must certify at the time of admission that a Medicare patient is expected to need care in the hospital for a period spanning two midnights to be considered an inpatient,” the release also said.

The so-called doc-fix bill recently approved by Congress included a six-month extension before compliance would be enforced for the two-midnight rule. AHA apparently plans to use that time contesting it in court. 

The existing two-midnight rule says admitting physicians must have good reason to believe that a patient will need two nights in the hospital before Medicare will pay full inpatient rates under Part A for the stay. Lacking such documentation, Medicare auditors will generally classify the stay as outpatient observation, which pays hospitals much less under Part B and sticks the patient with a 20% copayment. That rule went into effect Oct. 1. But it was modified so that Medicare’s aggressive recovery audit contractors could not overturn claims under the new policy until Sept. 30, 2014.

The enacted legislation requires Medicare to extend that recovery-auditing moratorium until March 31, 2015. It also gives Medicare officials the discretion to extend what’s known as the “probe and educate” process until the same date next year. Under that process, a different set of companies, known as Medicare administrative contractors, can audit a small number of short-stay inpatient claims and train hospitals on how to submit more accurate bills.

Joining AHA in its suits are the Greater New York Hospital Association, Healthcare Association of New York State, New Jersey Hospital Association and Hospital & Healthsystem Association of Pennsylvania. The hospital plaintiffs are Wake Forest Baptist Medical Center, Winston-Salem, N.C.; Mount Sinai Hospital, New York; and hospitals that are part of Phoenix-based Banner Health and Einstein Healthcare Network, Philadelphia, the AHA release detailed. The lawsuits were filed in the U.S. District Court for the District of Columbia.

Filed Under: Medicare, News and Updates

Previous Post: « PPACA costs fall as premiums beat forecast
Next Post: Fed fears PPACA could control costs »

You might also enjoy...

insurance sales tips for uncertain marketsTips for Insurance Agents Overcoming Sales Objections During Seasons of Uncertainty

Considering the state of the world, you never know what someone might be dealing with and why they aren’t ready to make a decision about insurance. While hearing “no” might not be the best feeling, don’t count your losses too quickly. Before you give up on […]

Read More
We Had Fun at Our Company Picnic!

Every year at AgentLink we host an event to gather all our team members together for some casual fun. This year, for the first time, we expanded the event and had a huge picnic that included all our family members. We had 85 people join us […]

Read More

Don’t forget to browse the free tools and resources we offer our agents and prospects, including our popular online quoting tools

Download the Digital Marketing Guide

Go to Resources

Get Contracted Now

Contract with us, to get appointed with your desired carriers

Please enter your email address below  to stay up-to-date with changes in the industry.

  • This field is for validation purposes and should be left unchanged.

Copyright © 2021 · Showcase Pro on Genesis Framework · WordPress · Log in

  • About
  • Contact
  • Careers
  • Life
  • Senior
  • Group Benefits
  • Concierge Services

Agent Login

Resources

Tools

Free Marketing Guide

1-800-960-1371

AgentLink Kentucky Office
2001 Lake Point Way, PO Box 23570
Louisville, KY 40223
Toll Free: 800.960.1371
Direct: 502.245.1371
Fax: 502.245.0978

AgentLink Indiana Office
3077 East 98th Street, Suite 135
Indianapolis, IN 46280
Toll Free: 866.462.9067
Direct: 317.569.8490
Fax: 317.569.8705

Copyright © 2020 AgentLink. All Rights Reserved.
Website Design and Digital Marketing by The Marketing Squad

  • Senior Products
  • Quoting Tool
  • Get Contracted
  • Brittney: 502-245-1371
  • Life Products
  • Quoting Tool
  • Get Contracted
  • Scott: (502) 245-1371
  • Products
    ▼
    • Life
      ▼
      • Info
      • Products
      • AML Training
      • Quoting Tool
    • Senior
      ▼
      • Info
      • Products
      • Certifications
      • Compliance
      • Quoting Tool
    • Group Benefits
      ▼
      • Info
      • Products
      • Our Process
      • Group Enrollment Form
    • Individual Benefits
      ▼
      • Info
      • Products
      • Our Process
      • Enrollment Tool
    • See our Concierge Services
  • Tools
  • Resources
    ▼
    • Marketing Guide
    • Carrier Links
    • Group Compliance Resources
    • Sales Webinars
    • Training Webinars
    • Insurance Marketing Webinars
  • About
  • Contact Us
  •  1-800-960-1371
  • Life Quoting Tool
  • Senior Quoting Tool
  • Marketing Guide
  • Blog