The CMS Two-Midnight Rule and short-stay audits are here to stay, impacting inpatient and outpatient admissions, ASC procedures, and Medicare Parts C & D. New for 2024, the Two-Midnight Rule applies to Medicare Advantage patients, requiring differentiation between Medicare plans affecting Case Managers, Utilization Review, and operational processes and knowledge of a vital distinction between these patients that influences post-discharge medical reviews and compliance risk. Join Michael G. Calahan for a comprehensive webcast covering federal laws for all admission processes. Gain the knowledge needed to navigate audits effectively and optimize patient access points, personnel, and compliance strategies. Learn Two-Midnight Rule essentials, Medicare Advantage implications, and compliance best practices. Discover operational insights for short-stay admissions, outpatient observation, and the ever-changing Inpatient-Only Listing.
With the 2024 Proposed Rules impacting inpatient and outpatient admissions, ASC procedures, and Medicare Parts C & D, one thing is clear: the various aspects of the Two-Midnight Rule are firmly in place for short-stay admissions.
In a significant development for 2024, the Two-Midnight Rule now extends to Medicare Advantage patients (Medicare Parts C & D). While admitting providers often find traditional Medicare and Medicare Advantage patients indistinguishable, administrative grouping and processing differences can affect patient case management. Case Managers, Utilization Review teams, and hospital staff must now distinguish between these groups to ensure compliance with the Two-Midnight Rule.
Moreover, a crucial difference between traditional Medicare and Medicare Advantage patients directly impacts post-discharge medical reviews and compliance risk. As traditional Medicare short-stay admits potentially meeting Two-Midnight Rule criteria face renewed Quality Improvement Organization (QIO) audits, understanding compliance nuances is paramount.
This webcast, led by esteemed expert, Michael G. Calahan, PA, MBA, Certified Compliance Officer, Certified Clinical Documentation Integrity, Certified Forensic Healthcare Auditor, offers a comprehensive exploration of Two-Midnight Rule essentials. He’ll delve into the implications for Medicare Advantage patients, providing a clear roadmap for navigating the evolving landscape to help you ensure your facility is well-equipped to handle federal and Medicare Advantage audits effectively. Gain insights into patient access points, personnel roles, and compliance requirements, ultimately enhancing your hospital’s operational efficiency and risk mitigation strategies.
Case Managers, QA/UR Staff, UR Committee Members, In-house & External Physician Advisors