Two-Midnight Rule Delay Act of 2013

Summary

Two-Midnight Rule Delay Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from enforcing the two-midnight rule to a hospital for which payment is made under title XVIII (Medicare) of the Social Security Act for admissions occurring before October 1, 2014. (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.) Applies such prohibition to Medicare review contracts. Prohibits Medicare review contractors from denying a claim for inpartient hospital services furnished by a hospital, or inpatient critical access hospital services furnished by a critical access hospital, for discharges occurring before October 1, 2014: (1) for 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) for requirements for orders, certifications, or recertifications, and associated documentation relating to such matters. 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. Directs the Secretary to develop: (1) a Medicare hospital payment methodology for short inpatient hospital stays; (2) 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 servives; and (3) a second crosswalk between Diagnosis-Related Group (DRG) codes for inpatient hospital services and Ambulatory Payment Class codes for outpatient hospital services.

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Timeline

1. 11 December 2013

   Introduced

   Referred to the House Committee on Ways and Means.

   Source: IntroReferral

2. 11 December 2013

   Introduced

   Introduced in House

   Source: IntroReferral

3. 11 December 2013

   Introduced

   Introduced in House

   Source: IntroReferral

Votes

No vote records are attached yet.

Versions

• Introduced in House · 11 December 2013 · Official file

Documents

3 official files

• Introduced in House (text)

  Introduced in House · EN · 11 December 2013

  ViewDownloadOpen at official source

• Introduced in House (PDF)

  Introduced in House · EN · 11 December 2013

  ViewDownloadOpen at official source

• Introduced in House

  summary · EN · 11 December 2013

  Open at official source

Sponsors

• Rep. Gerlach, Jim [R-PA-6] · R · Sponsor
• JOSEPH CROWLEY · D · Sponsor
• Tom Reed · R · Sponsor
• Peter Roskam · R · Sponsor
• RON KIND · D · Sponsor
• Lynn Jenkins · R · Cosponsor
• Michael Burgess · R · Cosponsor
• David Joyce · R · Cosponsor
• Rep. Grimm, Michael G. [R-NY-11] · R · Cosponsor
• Patrick Meehan · R · Cosponsor
• Paul Tonko · D · Cosponsor
• PETER KING · R · Cosponsor
• Rep. Clarke, Yvette D. [D-NY-9] · D · Cosponsor
• Rep. Nadler, Jerrold [D-NY-12] · D · Cosponsor
• Rep. Rangel, Charles B. [D-NY-19] · D · Cosponsor
• Rep. Schwartz, Allyson Y. [D-PA-13] · D · Cosponsor
• CAROLYN MALONEY · D · Cosponsor
• Brian Higgins · D · Cosponsor
• Rep. Huelskamp, Tim [R-KS-1] · R · Cosponsor
• Kevin Cramer · R · Cosponsor
• Gregg Harper · R · Cosponsor
• David Roe · R · Cosponsor
• Rep. Gibson, Christopher P. [R-NY-19] · R · Cosponsor
• Mark Meadows · R · Cosponsor
• JOSE SERRANO · D · Cosponsor
• ROBERT BRADY · D · Cosponsor
• Sanford Bishop · D · Cosponsor
• Rep. Owens, William L. [D-NY-21] · D · Cosponsor
• Sean Maloney · D · Cosponsor
• Rep. Heck, Joseph J. [R-NV-3] · R · Cosponsor
• Rep. Fattah, Chaka [D-PA-2] · D · Cosponsor
• Rep. Meeks, Gregory W. [D-NY-5] · D · Cosponsor
• Rep. Maffei, Daniel B. [D-NY-24] · D · Cosponsor
• Rep. Barrow, John [D-GA-12] · D · Cosponsor
• NITA LOWEY · D · Cosponsor
• Rep. Meng, Grace [D-NY-6] · D · Cosponsor
• Rep. Forbes, J. Randy [R-VA-4] · R · Cosponsor
• Rep. McCarthy, Carolyn [D-NY-4] · D · Cosponsor
• Niki Tsongas · D · Cosponsor
• Rep. Israel, Steve [D-NY-3] · D · Cosponsor
• ELIOT ENGEL · D · Cosponsor
• Rep. Hanna, Richard L. [R-NY-22] · R · Cosponsor
• PATRICK TIBERI · R · Cosponsor
• Trent Franks · R · Cosponsor
• Charles Dent · R · Cosponsor
• Sen. Gardner, Cory [R-CO] · R · Cosponsor
• Rep. Lynch, Stephen F. [D-MA-8] · D · Cosponsor
• James McGovern · D · Cosponsor

Showing 48 of 160 sponsors and actors.

Related records

• related to ← Two-Midnight Rule Coordination and Improvement Act of 2014