Surgery News - September 2008 - (Page 10) 10 PRACTICE TRENDS SURGERY NEWS • S E P T E M B E R 2 0 0 8 More Coverage Denial Planned Never Events • from page 1 to pay because somebody got a hospitalacquired condition,” Mr. Weems said. “This is about changing hospitals and making them safer places.” The CMS originally had proposed adding nine new conditions to the preventable conditions nonpayment list. Agency officials pared down the list after public comments raised questioned about including the other conditions. Some conditions that were not included in the final rule are delirium, ventilator-associated fective patient safety approach would be to encourage compliance with evidencebased guidelines by health care professionals.” CMS officials estimate that the nonpayment for preventable errors policy will save Medicare about $20 million a year. However, the policy is not about saving money, Kerry Weems, CMS acting administrator, said during a press conference. “I would be perfectly happy if we never came to a point where we didn’t have pneumonia, Staphylococcus aureus septicemia, Clostridium difficile–associated disease, legionnaires’ disease, and iatrogenic pneumothorax. However, those conditions may appear in future proposals once the agency has refined them, according to Mr. Weems. The CMS also is in talks with the National Quality Forum, the Agency for Healthcare Research and Quality, the Leapfrog Group for Patient Safety, and others about expanding the list of never events and considering how to expand the nonpayment policy to nonhospital settings such as nursing homes and home health agencies. American College of Surgeons 94th annual Clinical Congress October 12–16, 2008: San Francisco, CA Moscone Convention Center Save the Date! In addition to the expansion of the conditions on the preventable hospital-acquired conditions list, CMS is also beginning to develop three National Coverage Determinations to deny Medicare coverage for three never events—surgery on the wrong body part, surgery on the wrong patient, and wrong surgery performed on a patient. “These national coverage decisions will mandate what seems obvious—never events should never occur,” Mr. Weems said. “They should not be reimbursed by the Medicare trust fund.” A proposed decision memorandum on these surgical errors is scheduled to be issued by next February and is expected to be made final by the end of next April. Including these events in Medicare’s coverage policy also would apply to Medicare Advantage plans. Medicare Advantage plans are required to follow all Medicare fee-for-service coverage policies, even when those policies differ from their commercial practices, according to the CMS. The CMS also sent a letter to state Medicaid directors to encourage states to adopt similar policies on payment for preventable hospital-acquired conditions. The letter also provides information on how states can adopt the policies outlined in the final Medicare inpatient prospective payment system regulation. Nearly 20 states are considering methods to eliminate payment for certain never events, or already have them in place, according to the CMS. Finally, as part of the Acute Care Inpatient Prospective Payment System final rule, the CMS is adding 13 new measures to the Reporting Hospital Quality Data for Annual Payment Update program. Under the program, hospitals are required to report quality data publicly on the Medicare Hospital Compare Web site in order to receive their full payment update. The payment implications for the new quality measures will take effect in fiscal year 2010. “Not only will the measures promote quality improvements by hospitals and their staff, they will also allow patients to compare different hospitals, to [help them] decide where they will receive the best care,” Mr. Weems said. ■ Eight Preventable Conditions Cited currently lists eight ventable health care–acquired Medicareunder its nonpaymentpreconditions Join us in San Francisco for the 94th annual Clinical Congress. As always, it will be an educational opportunity you won’t want to miss! Please be sure to visit www.facs.org in the coming months for more details regarding the educational program, registration, housing, and transportation. policy and will not reimburse hospitals for secondary diagnoses associated with these conditions if acquired after hospital admission: Foreign object retained after surgery. Air embolism. Blood incompatibility. Pressure ulcer at stages III and IV. Falls and trauma. Catheter-associated urinary tract infection. Vascular catheter–associated infection. Mediastinitis after coronary artery bypass graft. http://www.facs.org http://www.facs.org
Table of Contents Feed for the Digital Edition of Surgery News - September 2008 Surgery News - September 2008 Contents Appreciation Low Scores News From the College: New Leader Practice Trends: High Price to Pay Surgery News - September 2008 Surgery News - September 2008 - Contents (Page 1) Surgery News - September 2008 - Contents (Page 2) Surgery News - September 2008 - Contents (Page 3) Surgery News - September 2008 - Appreciation (Page 4) Surgery News - September 2008 - Low Scores (Page 5) Surgery News - September 2008 - Low Scores (Page 6) Surgery News - September 2008 - Low Scores (Page 7) Surgery News - September 2008 - News From the College: New Leader (Page 8) Surgery News - September 2008 - News From the College: New Leader (Page 9) Surgery News - September 2008 - News From the College: New Leader (Page 10) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 11) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 12) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 13) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 14) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 15) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 16)
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