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Expert Analysis

How To Work With CMS' New 2-Midnight Benchmark

Law360, New York (August 23, 2013, 2:38 PM EDT) -- On Aug. 2, 2013, the Centers for Medicare and Medicaid Services issued an advance copy of its final rulemaking that adopts a new approach to evaluating the medical necessity of inpatient hospital admissions. Because inpatient admission typically results in higher levels of Medicare reimbursement than outpatient services, fraud enforcement agencies have critically scrutinized inpatient admissions involving short stays — usually one day or less — to determine whether the services actually required an inpatient level of care. The new rule takes effect Oct. 1, 2013....

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