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AAMC Joins Letter to Burwell Opposing Two Midnights Rule

June 12, 2015—The AAMC joined eight health care associations and patient interest groups, including the American Medical Association and the American Medical Group Association, in signing a June 8 letter  to Secretary of Health and Human Services (HHS) Sylvia Burwell, regarding the Centers for Medicare and Medicaid Services (CMS) short-stay hospital inpatient admission policy, known as the “two midnights” rule [see Washington Highlights, May 22].

The letter stresses stakeholder concerns that the two midnights rule “second guesses the medical judgment of physicians and potentially adversely impacts patients and health outcomes.” The letter specifically states that “utilizing a strict time-based framework as a means to classify and treat patients erodes a provider’s ability to improve health outcomes through personalized, evidence-based clinical care.”

The groups affirm that similar sentiments are “shared by stakeholders broadly, including patients, doctors, hospitals, and most recently the independent federal government advisory body, Medicare Payment Advisory Commission (MedPAC) which voted unanimously on a draft recommendation to withdraw the Two Midnights’ rule because it detracts from admission criteria that depend upon clinical judgment.”

Finally, the groups urge CMS to “rescind the ‘Two Midnights’ rule via the fiscal year (FY) 2016 Inpatient Prospective Payment System (IPPS) rulemaking process,” and work with stakeholders to “identify alternative policy ideas that: restore clinical judgment to the hospital admission process; preserve consistent approaches to clinical and utilization review processes; and ensure transparency regarding beneficiary financial accountability.”


Len Marquez
Director, Government Relations
Telephone: 202-862-6281

Courtney Summers
Senior Legislative Analyst
Telephone: 202-862-6042


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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.

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Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806