Leaders of the American Hospital Association and American Medical Association have sent a joint letter to CMS Administrator Marilyn Tavenner asking for changes, including a delay, to Medicare’s new “Two-Midnight Policy” that will cut Medicare Part A payments for certain inpatient stays. AHA CEO Rich Umbdenstock and AMA CEO James Madara, M.D., argue that in addition to financial repercussions, the policy undermines medical judgment and safe care practices, and does not give adequate time to revamp software systems and policies and procedures. Here is the letter, dated November 8:

“On behalf of our members, who include the vast majority of health care providers seeking to implement the inpatient admission and review criteria (the two-midnight policy) finalized by the Centers for Medicare & Medicaid Services in the fiscal year 2014 Hospital Inpatient Prospective Payment System final rule, the American Hospital Association and the American Medical Association appreciate the opportunity to share with you our concerns with the two-midnight policy. Specifically, we urge the agency to delay enforcement of the two-midnight policy until October 1, 2014, and to convene a meeting with all affected stakeholders to discuss workable, comprehensive solutions to the rise in observation care.

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