Two Midnight Rule: Our UM practices will remain unchanged
At Priority Health, our members’ health is our top priority. This is why we’ve built a robust utilization management (UM) program, working with our contracted providers to ensure our members get the right care at the right time.
Through this UM program, we review every inpatient admission upon admission, not just short stays or those that meet or exceed two midnights. CMS affords us this opportunity as a Medicare Advantage (MA) plan, and its recent 2024 policy update document doesn’t change that.
Our UM program will remain unchanged, and our providers will continue to work with us as they have.