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Medicare, Observation Care, and the Two-Midnight Rule (CRS Report for Congress)

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Release Date Revised Nov. 18, 2015
Report Number IF10264
Report Type In Focus
Authors Marco A. Villagrana
Source Agency Congressional Research Service
Older Revisions
  • Premium   July 23, 2015 (2 pages, $24.95) add
Summary:

Medicare cost sharing and posthospital coverage can depend on whether a beneficiary was admitted to the hospital and received treatment as an inpatient or received treatment as an outpatient. Some beneficiaries have been surprised to learn that despite having received treatment overnight in a hospital bed during their hospital stay, they were never formally admitted but instead were under observation as an outpatient. The Two-Midnight Rule implemented by the Centers for Medicare & Medicaid Services (CMS) is intended to clarify to hospitals when an inpatient admission is considered medically necessary.