Two-Midnight Rule: Get Ready for Increased Auditor Scrutiny

Don’t let the lull in federal audits fool you. After taking a pandemic-related breather, a variety of audit entities are resuming their rigorous scrutiny of hospital claims — and compliance with the two-midnight rule is one of their top targets. The Office of the Inspector General (OIG), quality improvement organizations (QIOs) and other entities will be diving into short-stay inpatient admissions, looking for violations of the two-midnight rule in its latest iteration. Expect these audits to result in widespread repayments, fines and other penalties.

Take preemptive action now with guidance from this exclusive RACmonitor webcast. Our presenter, Certified Compliance Officer Michael G. Calahan, will cover important, often overlooked, aspects of compliance with the two-midnight rule: the various patient admission gateways involved, crucial workflows and cross-departmental protocols, best practices to mitigate your risks, documentation requirements (including recent changes to physician orders) and much more. In just 60 minutes, you’ll gain a clearer understanding of common vulnerabilities and how to fix them before the auditors come calling.

Why This Is Relevant:

Provisions of the two-midnight rule are complicated and constantly changing. But that won’t let you off the hook when auditors take a close look at your hospital’s short-stay inpatient admissions. You can avoid adverse outcomes by attending this RACmonitor webcast and learning how to solidify your compliance with the two-midnight rule.

Learning Objectives:

• Know essential requirements and continuing areas of vulnerability under the two-midnight rule, applicable to a hospital’s patient admission gateways
• Identify relevant outpatient observation requirements and risk areas
• Understand the CMS inpatient-only (IPO) list updates and how they affect two-midnight rule admits and observation stays
• Learn requirements of inpatient admit orders, as well as how they impact the validity of short-stay inpatient admissions and associated observation stays
• Identify the weakest areas specific to identifying, correcting and managing admits classified as “two midnight or less stays” and related outpatient observation services

Who Should Attend:

Utilization review, case management, quality assurance, revenue integrity, revenue cycle, compliance, billing and coding staff, as well as physician advisors.