Healthcare Executive - November/December 2013 - 58

Public Policy Update

delivered), billing errors (e.g., wrong
codes used) and professional judgment
(e.g., procedures unsupported by medical record documentation).
The ongoing concern about billing
errors and inappropriate professional
judgment resulted in the creation of
the Recovery Audit Contractor program, and the proposed payment
rule takes this initiative to another
level. Called the “two midnight”
rule, it is one of the most controversial policies proposed by Medicare.
This policy creates a presumption
that an inpatient admission is reasonable and necessary if the admitting physician expects the patient to
require a stay spanning at least two
midnights or if the patient requires a
procedure on the inpatient-only list.

As the AHA stated in its comments
regarding the proposed rule “Our
member hospitals tell us that the
medical judgment of treating physicians is all too often second guessed
by RACs, which are able to evaluate a
beneficiary’s admission in hindsight,
looking at the entire medical record
rather than only the information that
was known to the physician at the
time of the admission.”
Although Medicare received many
strong comments from providers on
this rule, it will nonetheless go into
effect. However, because of industry
concerns Medicare will delay
enforcement of the rule until at least
January 1, 2014, to assure that it is
working properly. The line between
inpatient and observation status will

continue to be debated, particularly
by hospitals and RACs.
Make policy payments. The proposed rule continues payments for
medical education, community access
hospitals and disproportionate share
hospitals—all payments based in the
policy that Medicare should fund
certain aspects of the American
healthcare system that are critical to
the system’s well-being.
The DSH formula is detailed in the
rule and is designed to reduce DSH
payments as more individuals gain
health insurance through the
exchanges. The effective payment of
DSH is particularly difficult to forecast as it will be based on a hospital’s
base DSH payment, “reduced for
use promo code

HCCAREER

through 12/31/13

HAP Has
You Covered
with Books
from Leading
Experts
Order code: 2189
$82.00 + shipping
Now $57.40

Healthcare Executive
58 ND13_HAP_TylerBjork_test_alt.indd
nOv/DEC 2013

1

Order code: 2163
$70.00 + shipping
Now $49.00

To learn more and to purchase these
books online, visit ache.org/HAP. To order
by phone, call the ACHE/HAP Order
Fulfillment Center at (301) 362-6905.
9/23/13 3:36 PM



Healthcare Executive - November/December 2013

Table of Contents for the Digital Edition of Healthcare Executive - November/December 2013

Healthcare Executive - November/December 2013
Contents
ACHE Online
Take Note
Perspectives
Managing Your Career in Transformative Times
Generation Now: The New Era of Leadership
Aspirations of a Servant Leader
Professional Pointers
Healthcare Management Ethics
Satisfying Your Customers
Community Health Innovations
Public Policy Update
Careers
Governance Insights
Improving Patient Care
CEO Focus
Executive News
On the Move
Member Accolades
Chapter News
Professional Development Calendar
2013 Editorial Index
Healthcare Executive - November/December 2013 - Healthcare Executive - November/December 2013
Healthcare Executive - November/December 2013 - Cover2
Healthcare Executive - November/December 2013 - Contents
Healthcare Executive - November/December 2013 - 2
Healthcare Executive - November/December 2013 - 3
Healthcare Executive - November/December 2013 - ACHE Online
Healthcare Executive - November/December 2013 - 5
Healthcare Executive - November/December 2013 - Take Note
Healthcare Executive - November/December 2013 - 7
Healthcare Executive - November/December 2013 - Perspectives
Healthcare Executive - November/December 2013 - 9
Healthcare Executive - November/December 2013 - Managing Your Career in Transformative Times
Healthcare Executive - November/December 2013 - 11
Healthcare Executive - November/December 2013 - 12
Healthcare Executive - November/December 2013 - 13
Healthcare Executive - November/December 2013 - 14
Healthcare Executive - November/December 2013 - 15
Healthcare Executive - November/December 2013 - 16
Healthcare Executive - November/December 2013 - 17
Healthcare Executive - November/December 2013 - 18
Healthcare Executive - November/December 2013 - 19
Healthcare Executive - November/December 2013 - Generation Now: The New Era of Leadership
Healthcare Executive - November/December 2013 - 21
Healthcare Executive - November/December 2013 - 22
Healthcare Executive - November/December 2013 - 23
Healthcare Executive - November/December 2013 - 24
Healthcare Executive - November/December 2013 - 25
Healthcare Executive - November/December 2013 - 26
Healthcare Executive - November/December 2013 - 27
Healthcare Executive - November/December 2013 - 28
Healthcare Executive - November/December 2013 - 29
Healthcare Executive - November/December 2013 - Aspirations of a Servant Leader
Healthcare Executive - November/December 2013 - 31
Healthcare Executive - November/December 2013 - 32
Healthcare Executive - November/December 2013 - 33
Healthcare Executive - November/December 2013 - 34
Healthcare Executive - November/December 2013 - 35
Healthcare Executive - November/December 2013 - 36
Healthcare Executive - November/December 2013 - 37
Healthcare Executive - November/December 2013 - 38
Healthcare Executive - November/December 2013 - 39
Healthcare Executive - November/December 2013 - Professional Pointers
Healthcare Executive - November/December 2013 - 41
Healthcare Executive - November/December 2013 - Healthcare Management Ethics
Healthcare Executive - November/December 2013 - 43
Healthcare Executive - November/December 2013 - 44
Healthcare Executive - November/December 2013 - 45
Healthcare Executive - November/December 2013 - 46
Healthcare Executive - November/December 2013 - 47
Healthcare Executive - November/December 2013 - Satisfying Your Customers
Healthcare Executive - November/December 2013 - 49
Healthcare Executive - November/December 2013 - 50
Healthcare Executive - November/December 2013 - 51
Healthcare Executive - November/December 2013 - Community Health Innovations
Healthcare Executive - November/December 2013 - 53
Healthcare Executive - November/December 2013 - 54
Healthcare Executive - November/December 2013 - 55
Healthcare Executive - November/December 2013 - Public Policy Update
Healthcare Executive - November/December 2013 - 57
Healthcare Executive - November/December 2013 - 58
Healthcare Executive - November/December 2013 - 59
Healthcare Executive - November/December 2013 - 60
Healthcare Executive - November/December 2013 - 61
Healthcare Executive - November/December 2013 - Careers
Healthcare Executive - November/December 2013 - 63
Healthcare Executive - November/December 2013 - 64
Healthcare Executive - November/December 2013 - 65
Healthcare Executive - November/December 2013 - Governance Insights
Healthcare Executive - November/December 2013 - 67
Healthcare Executive - November/December 2013 - 68
Healthcare Executive - November/December 2013 - 69
Healthcare Executive - November/December 2013 - Improving Patient Care
Healthcare Executive - November/December 2013 - 71
Healthcare Executive - November/December 2013 - 72
Healthcare Executive - November/December 2013 - 73
Healthcare Executive - November/December 2013 - 74
Healthcare Executive - November/December 2013 - 75
Healthcare Executive - November/December 2013 - CEO Focus
Healthcare Executive - November/December 2013 - 77
Healthcare Executive - November/December 2013 - 78
Healthcare Executive - November/December 2013 - 79
Healthcare Executive - November/December 2013 - Executive News
Healthcare Executive - November/December 2013 - 81
Healthcare Executive - November/December 2013 - 82
Healthcare Executive - November/December 2013 - 83
Healthcare Executive - November/December 2013 - On the Move
Healthcare Executive - November/December 2013 - 85
Healthcare Executive - November/December 2013 - 86
Healthcare Executive - November/December 2013 - 87
Healthcare Executive - November/December 2013 - Member Accolades
Healthcare Executive - November/December 2013 - 89
Healthcare Executive - November/December 2013 - Chapter News
Healthcare Executive - November/December 2013 - 91
Healthcare Executive - November/December 2013 - Professional Development Calendar
Healthcare Executive - November/December 2013 - 93
Healthcare Executive - November/December 2013 - 2013 Editorial Index
Healthcare Executive - November/December 2013 - 95
Healthcare Executive - November/December 2013 - 96
Healthcare Executive - November/December 2013 - Cover3
Healthcare Executive - November/December 2013 - Cover4
https://www.nxtbook.com/nxtbooks/ache/he_20181112
https://www.nxtbook.com/nxtbooks/ache/he_20180910
https://www.nxtbook.com/nxtbooks/ache/he_20180708
https://www.nxtbook.com/nxtbooks/ache/he_20180506
https://www.nxtbook.com/nxtbooks/ache/he_20180304
https://www.nxtbook.com/nxtbooks/ache/he_20180102
https://www.nxtbook.com/nxtbooks/ache/he_20171112
https://www.nxtbook.com/nxtbooks/ache/he_20170910
https://www.nxtbook.com/nxtbooks/ache/he_20170708
https://www.nxtbook.com/nxtbooks/ache/he_20170506
https://www.nxtbook.com/nxtbooks/ache/he_20170304
https://www.nxtbook.com/nxtbooks/ache/he_20170102
https://www.nxtbook.com/nxtbooks/ache/he_20161112
https://www.nxtbook.com/nxtbooks/ache/he_20160910
https://www.nxtbook.com/nxtbooks/ache/he_20160708
https://www.nxtbook.com/nxtbooks/ache/he_20160506
https://www.nxtbook.com/nxtbooks/ache/he_20160304
https://www.nxtbook.com/nxtbooks/ache/he_20160102
https://www.nxtbook.com/nxtbooks/ache/he_20151112
https://www.nxtbook.com/nxtbooks/ache/he_20150910
https://www.nxtbook.com/nxtbooks/ache/he_20150708
https://www.nxtbook.com/nxtbooks/ache/he_20150506
https://www.nxtbook.com/nxtbooks/ache/he_20150304
https://www.nxtbook.com/nxtbooks/ache/he_20150102
https://www.nxtbook.com/nxtbooks/ache/he_20141112
https://www.nxtbook.com/nxtbooks/ache/he_20140910
https://www.nxtbook.com/nxtbooks/ache/he_20140708
https://www.nxtbook.com/nxtbooks/ache/he_20140506
https://www.nxtbook.com/nxtbooks/ache/he_20140304
https://www.nxtbook.com/nxtbooks/ache/he_20140102
https://www.nxtbook.com/nxtbooks/ache/he_20131112
https://www.nxtbook.com/nxtbooks/ache/he_20130910
https://www.nxtbook.com/nxtbooks/ache/he_20130708
https://www.nxtbook.com/nxtbooks/ache/he_20130506
https://www.nxtbook.com/nxtbooks/ache/he_20130304
https://www.nxtbook.com/nxtbooks/ache/he_20130102
https://www.nxtbookmedia.com