Hospital nurses, medical residents and physician assistants can all write the orders to admit Medicare beneficiaries to the hospital. But newly clarified CMS rules say a physician must sign off on the admitting paperwork and “accept responsibility” for the decision before the patient is discharged.
The guidance was published (PDF) as part of the ongoing effort to define the CMS' new two-midnight policy, which says admitting physicians must have good reason to believe that a patient will require two nights in the hospital to quality for Medicare's higher-paying hospital rates. Otherwise, the care is considered outpatient, which pays less.
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