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CMS proposal would halt payment for nine more hospital-acquired conditions

Quality Improvement Monitor, May 2, 2008

A new CMS proposal would add nine hospital-acquired conditions (HAC) to the list of conditions it will no longer pay for and require organizations to report on 43 more quality measures to receive their full Medicare reimbursement.

The proposal, which applies to all facilities paid under the inpatient prospective payment system, was unveiled April 14. Hospitals have until June 13 to comment on the proposal, and CMS will issue a final rule on or before August 1.

Under the proposal, CMS would no longer pay for the following HACs:

  • 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
  • Clostridium difficile–associated disease

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