Medicare Attempts To Prevent Hospital Injuries

We have previously written about the federal government’s new policy restricting Medicare payments to hospitals for the extra care required to treat patients harmed by certain preventable infections and medical errors. Now the federal government is expanding the program in an attempt to to provide hospitals with a financial incentive to improve patient care.
Under the expanded policy, Medicare will not make payments to hospitals for care needed after patients suffer from certain surgical site infections (specifically for total knee replacement, laparascopic gastric bypass and gastroeneterostomoy, and ligation and stripping of varicose veins); deep vein thrombosis/pulmonary embolism (formation/movement of a blood clot); and extreme blood sugar derangement.
Medicare considered adding a number of other hospital acquired conditions to the nonpayment list: staphylococcus aureus septicemia (bloodstream infection); Clostridium difficile associated disease (a bacterium that causes severe diarrhea and more serious intestinal conditions such as colitis); Legionnaires’ disease (a type of pneumonia caused by a specific bacterium); Iatrogenic pneumothorax (collapse of the lung) delirium; and ventilator-associated pneumonia. However, none of these hospital acquired conditions were included in the final nonpayment rules just issued by the agency to be implemented on October 1, 2009.
Last year, Medicare adopted rules to begin the nonpayment policy for certain hospital acquired conditions beginning October 1, 2008. These initial nonpayment rules cover certain urinary tract infections, staph aureaus bloodstream infections, and four other hospital errors unrelated to infections: serious bed sores, objects left in patients’ bodies following surgery, blood incompatibility, and air embolism.