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Code · BILL · 113th Congress · S. 2157 (Placed on Calendar Senate) — To amend titles XVIII and XIX of the Social Security Act to repeal the Medicare sustainable growth rate and to improv... · Sec. 404

Sec. 404. Criteria for medically necessary, short inpatient hospital stays

183 words·~1 min read·/bill/113/s/2157/pcs/section-404

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The Secretary of Health and Human Services shall consult with, and seek input from, interested stakeholders to determine appropriate criteria for payment under the Medicare program under title XVIII of the Social Security Act of an inpatient hospital admission that— is medically necessary; and is an inpatient hospital stay that is less than two midnights, as described in section 412.3 of title 42, Code of Federal Regulation, as finalized in the final rule published by the Centers for Medicare & Medicaid Services in the Federal Register on August 19, 2013 (78 Federal Register 50496) entitled Medicare Program;
Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2014 Rates; Quality Reporting Requirements for Specific Providers; Hospital Conditions of Participation; Payment Policies Related to Patient Status . In subsection (a), the term interested stakeholders means the following: Hospitals. Physicians Medicare administrative contractors under section 1874A of the Social Security Act (42 U.S.C. 1395kk–1).
Recovery audit contractors under section 1893(h) of such Act ( 42 U.S.C. 1395ddd(h) ). Other parties determined appropriate by the Secretary.
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  • 42 USC 1395kk–1
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Sec. 404
Criteria for medically necessary, short inpatient hospital stays
Cite42 USC 1395kk–1
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