SURGICAL PERSPECTIVE
How Many Midnights? Admission Status for Elders With Small Bowel Obstruction Zara Cooper, MD, MSc, y Neha Goel, MD, z Lily Gutnik, MD, MPH, § Gally Reznor, MS, Elizabeth Lilley, MD, MPH, Katherine J. Williams, MPH, Ali Salim, MD, y Edward Kelly, MD,y and Michael J. Zinner, MD §
T
he Centers for Medicare & Medicaid Services (CMS) established the Two-Midnight Rule in 2013, in response to increasing hospital admissions for observation and rising out-of-pocket costs for beneficiaries.1 According to this rule, some surgical procedures, diagnostic tests, and treatments are eligible for inpatient coverage under Medicare Part A if the physician reasonably expects the patient to need a hospital stay that crosses 2 midnights (MN) and admits the patient on the basis of that expectation.2 Hospital stays
How Many Midnights? Admission Status for Elders With Small Bowel Obstruction Zara Cooper, MD, MSc, y Neha Goel, MD, z Lily Gutnik, MD, MPH, § Gally Reznor, MS, Elizabeth Lilley, MD, MPH, Katherine J. Williams, MPH, Ali Salim, MD, y Edward Kelly, MD,y and Michael J. Zinner, MD §
T
he Centers for Medicare & Medicaid Services (CMS) established the Two-Midnight Rule in 2013, in response to increasing hospital admissions for observation and rising out-of-pocket costs for beneficiaries.1 According to this rule, some surgical procedures, diagnostic tests, and treatments are eligible for inpatient coverage under Medicare Part A if the physician reasonably expects the patient to need a hospital stay that crosses 2 midnights (MN) and admits the patient on the basis of that expectation.2 Hospital stays
