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CMS proposes expansion to hospital-acquired conditions

Infection Control Monitor, April 18, 2008

Just as facilities begin to grapple with the fact the government won’t pay them for certain hospital-acquired conditions, the Centers for Medicare & Medicaid Services (CMS) has proposed expanding that list.

Under a proposed rule, CMS will add nine new conditions that if acquired during a hospital stay the government won’t reimburse hospitals for the cost of treatment. The original list contains three conditions directly related to IC, but could more than double if the proposed list is adopted. The proposed conditions include:

  • Surgical site infections following certain elective procedures
  • Legionnaires’ disease
  • Extreme blood sugar derangement
  • Iatrogenic pneumothorax 
  • Delirium
  • Ventilator-associated pneumonia
  • Deep vein thrombosis/Pulmonary embolism 
  • Staphylococcus aureus septicemia
  • C. diff-associated disease

According to CMS, “Beginning October 1, 2008, CMS will no longer pay hospitals at a higher rate for the original eight conditions or any conditions added to the list in the final rule.”

Comments on the proposed rule will be accepted through June 13, and CMS will respond to comments in a final rule to be issued on or before August 1, 2008. CMS’ proposed rule is scheduled for publication in the Federal Register, April 30. To view a draft of this document, go to www.hcpro.com/content/209532.cfm.

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