3.0.0 2082 2023-01-11T13:26:46Z 2023-01-11T13:26:46Z Senate S S 2014-03-05 113 ssfi00 Finance Committee Senate Standing Referred to 2014-03-06T00:01:41Z Two-Midnight Rule Delay Act of 2013 113 3698 HR 2013-12-11 Referred to the House Committee on Ways and Means. Related bill CRS 2014-03-05 ssfi00 Finance Committee Senate Read twice and referred to the Committee on Finance. IntroReferral 2014-03-05 Introduced in Senate IntroReferral 10000 9 Library of Congress M000639 Sen. Menendez, Robert [D-NJ] Robert Menendez D NJ N F000463 Sen. Fischer, Deb [R-NE] Deb Fischer R NE 2014-03-05 True B000944 Sen. Brown, Sherrod [D-OH] Sherrod Brown D OH 2014-03-12 False G000555 Sen. Gillibrand, Kirsten E. [D-NY] Kirsten Gillibrand D NY E. 2014-03-13 False S000148 Sen. Schumer, Charles E. [D-NY] Charles Schumer D NY E. 2014-03-13 False M000702 Sen. Mikulski, Barbara A. [D-MD] BARBARA MIKULSKI D MD ANN 2014-03-24 False K000367 Sen. Klobuchar, Amy [D-MN] Amy Klobuchar D MN 2014-03-25 False C001070 Sen. Casey, Robert P., Jr. [D-PA] Bob Casey D PA 2014-03-25 False F000457 Sen. Franken, Al [D-MN] Al Franken D MN 2014-03-26 False K000360 Sen. Kirk, Mark Steven [R-IL] MARK KIRK R IL STEVEN 2014-04-10 False H001046 Sen. Heinrich, Martin [D-NM] Martin Heinrich D NM T. 2014-05-14 False B001288 Sen. Booker, Cory A. [D-NJ] Cory Booker D NJ 2014-05-20 False M001176 Sen. Merkley, Jeff [D-OR] Jeff Merkley D OR 2014-06-19 False S000770 Sen. Stabenow, Debbie [D-MI] Debbie Stabenow D MI 2014-07-29 False B001230 Sen. Baldwin, Tammy [D-WI] Tammy Baldwin D WI 2014-07-30 False W000818 Sen. Walsh, John E. [D-MT] John Walsh D MT E. 2014-07-31 False C000127 Sen. Cantwell, Maria [D-WA] Maria Cantwell D WA 2014-09-17 False M001111 Sen. Murray, Patty [D-WA] Patty Murray D WA 2014-09-17 False Health Administrative law and regulatory procedures Department of Health and Human Services Hospital care Medicare Health 00 2014-03-05 Introduced in Senate 2014-05-12T21:55:51Z Two-Midnight Rule Coordination and Improvement Act of 2014 - Directs the Secretary of Health and Human Services (HHS) to develop appropriate criteria with regard to the two-midnight rule for payment under title XVIII (Medicare) of the Social Security Act for a short inpatient hospital stay.

(The two-midnight rule allows Medicare coverage of only hospital stays for which a physician admits to a hospital a beneficiary expected to require care that crosses two midnights, but generally denies coverage of care expected to require less than a two-midnight stay.)

Requires the criteria developed by the Secretary to: (1) account for medical necessity and the appropriateness of an inpatient stay that is less than the two-midnight benchmark, and (2) be developed in consultation with interested stakeholders.

Directs the Secretary to develop a budget-neutral Medicare payment methodology for hospitals for short inpatient hospital stays.

Allows the methodology to be: (1) a reduced payment amount than would otherwise apply to inpatient hospital services if paid for under the Medicare prospective payment schedule, or (2) an alternative payment methodology.

Directs the Secretary to develop: (1) general equivalency maps to link the relevant International Statistical Classification of Diseases and Related Health Problems (ICD)-10 codes (used to report medical diagnoses and inpatient procedures) to relevant Current Procedural Terminology (CPT) codes, and the relevant CPT codes to relevant ICD-10 codes, in order to permit comparison of inpatient hospital services and hospital outpatient department services; and (2) a second crosswalk between Diagnosis-Related Group (DRG) codes for inpatient hospital services and Ambulatory Payment Class (APC) codes for outpatient hospital services.

Prohibits the Secretary from enforcing the two-midnight rule for admissions occurring: (1) before October 1, 2014; and (2) on or after that date until October 1, 2015, or the new two-midnight rule criteria are implemented, if sooner (applicable date).

Prohibits a Medicare review contractor from denying a claim for inpatient hospital services furnished by a hospital, or inpatient critical access hospital services furnished by a critical access hospital, on the basis of the two-midnight rule for discharges occurring before the applicable date for: (1) medical necessity due to the length of an inpatient stay in such hospital or due to a determination that the services could have been provided on an outpatient basis; or (2) requirements for orders, certifications, or recertifications, and associated documentation relating to such matters.

Declares that nothing in this Act shall be construed to preclude the Secretary from continuing the conduct by Medicare administrative contractors of the Medicare Probe and Educate program for hospital admissions during the delayed enforcement of the two-midnight rule.

Prohibits the Secretary from increasing the sample of claims selected for prepayment review under the Medicare Probe and Educate program above the number and type established by the Secretary as of November 4, 2013, such as 10 claims for most hospitals and 25 claims for large hospitals.

]]> Two-Midnight Rule Coordination and Improvement Act of 2014 Display Title Two-Midnight Rule Coordination and Improvement Act of 2014 Official Title as Introduced A bill to provide for the development of criteria under the Medicare program for medically necessary short inpatient hospital stays, and for other purposes. Introduced in Senate IS Short Titles as Introduced Two-Midnight Rule Coordination and Improvement Act of 2014 Introduced in Senate 2014-03-05T05:00:00Z https://www.govinfo.gov/content/pkg/BILLS-113s2082is/xml/BILLS-113s2082is.xml 2014-03-05 Read twice and referred to the Committee on Finance. text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. Congressional Research Service, Library of Congress This file contains bill summaries and statuses for federal legislation. A bill summary describes the most significant provisions of a piece of legislation and details the effects the legislative text may have on current law and federal programs. Bill summaries are authored by the Congressional Research Service (CRS) of the Library of Congress. As stated in Public Law 91-510 (2 USC 166 (d)(6)), one of the duties of CRS is "to prepare summaries and digests of bills and resolutions of a public general nature introduced in the Senate or House of Representatives". For more information, refer to the User Guide that accompanies this file.