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OIG report: VULNERABILITIES REMAIN UNDER MEDICARE'S 2-MIDNIGHT HOSPITAL POLICY


OIG report: VULNERABILITIES REMAIN UNDER MEDICARE'S 2-MIDNIGHT HOSPITAL POLICY

Date Posted: Tuesday, December 20, 2016

 

What OIG Found OIG found that the number of inpatient stays decreased and the number of outpatient stays increased since the implementation of the 2-midnight policy.  Further, short inpatient stays decreased more than long outpatient stays. 

However, despite these changes, vulnerabilities still exist.   

  • Hospitals are billing for many short inpatient stays that are potentially inappropriate under the policy; Medicare paid almost $2.9 billion for these stays in FY 2014.
  • Medicare pays more for some short inpatient stays than for short outpatient stays, although the stays are for similar reasons.
  • Hospitals continue to bill for a large number of long outpatient stays.
  • An increased number of beneficiaries in outpatient stays pay more and have limited access to SNF services than they would as inpatients.
  • Hospitals continue to vary in how they use inpatient and outpatient stays.

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