The Centers for Medicare and Medicaid Services on April 30 plans to publish in the Federal Register a proposed rule that will require hospitals to report more conditions and quality measures to receive their expected Medicare reimbursements. The rule also could compel I.T. vendors to further increase the data capture and reporting capabilities of their software to help hospitals collect and report such data.
The rule would expand the list of conditions that Medicare will no longer cover beginning Oct. 1 unless hospitals report them as being present when a patient is first admitted to ensure accurate reimbursement. The initiative is designed to help reduce hospital-acquired infections. The new conditions are:
*Surgical site infections follow certain elective procedures;
*Legionnaires' disease;
*Extreme blood sugar derangement;
*Collapse of a lung;
*Delirium;
*Ventilator-associated pneumonia;
*Deep vein thrombosis/pulmonary embolism;
*Bloodstream infection; and
*Clostridium difficile associated disease.
Additionally, the rule would propose adding 43 new quality measures that hospitals must report to participate in CMS's hospital quality measure reporting program. The new measures, which will take effect Oct. 1, fall into the following categories:
*Surgical care improvement project;
*Hospital readmissions;
*Nursing care;
*Patient safety indicators developed by the Agency for Healthcare Research and Quality;
*Inpatient Quality Indicators developed by AHRQ;
*Venous thromboembolism measures;
*Stroke measures; and
*Cardiac surgery measures.
Comments on the proposed rule will be accepted through June 13. CMS will respond to comments in a final rule to be issued on or before Aug. 1.
For more information, go to cms.hhs.gov/apps/media/press_releases.asp.
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