Medicare Might Expand Hospital Complications It Will Not Pay To Treat
On Monday, CMS officials proposed new rules that would add nine conditions to the list of preventable conditions that Medicare will no longer pay hospitals to treat, the AP/San Francisco Chronicle reports (Freking, AP/San Francisco Chronicle, 4/14).
In August 2007, CMS announced that it no longer will reimburse hospitals for the treatment of certain "conditions that could reasonably have been prevented," and the facilities "cannot bill the beneficiary for any charges associated with the hospital-acquired complication."
The conditions include: falls; mediastinitis, an infection that can develop after heart surgery; urinary tract infections that result from improper use of catheters; pressure ulcers; and vascular infections that result from improper use of catheters.
In addition, the conditions include three "never events": objects left in the body during surgery, air embolisms and blood incompatibility (California Healthline, 8/20/07).
The nine preventable conditions proposed on Monday include:
- Surgical site infections following certain elective procedures;
- Legionnaire's disease;
- Extreme blood sugar derangement;
- Iatrogenic pneumothorax or collapsed lungs;
- Ventilator-associated pneumonia;
- Deep vein thrombosis or pulmonary embolism;
- Staphylococcus aureus septicemia or bloodstream infection; and
- Clostridium difficile associated disease (CMS release, 4/14).