CMS proposes stricter rules for hospital errors to save $50M yearly
CMS is trying to cut back payment for hospital errors to save money. Source: The National Medicare Congress  
The Centers for Medicare & Medicaid Services (CMS) has proposed adding nine new "never events," or preventable errors, for which it will not reimburse hospitals for extended care.

CMS has also added 43 new quality measures for which hospitals will have to report data, in order to receive the full annual payment update for their services.

The government said that the proposed rule, which brings the total of preventable errors for which it will not pay to 17, will save Medicare an estimated $50 million annually over the next three years, the Associated Press reported. 

Patient safety incidents cost the federal Medicare program $8.8 billion and resulted in 238,337 potentially preventable deaths during 2004 through 2006, according to HealthGrades' fifth annual Patient Safety in American Hospitals Study.

If enacted, the proposed changes will begin on Oct. 1, 2008.

The proposed rule expands two initiatives: the Hospital-Acquired Conditions (HAC) and the Hospital Quality Measure Reporting initiatives. Under the HAC initiative, beginning Oct. 1, Medicare will no longer pay hospitals at a higher rate for the increased costs of care that result when a patient is harmed by one of several preventable conditions they did not have when they were first admitted to the hospital.

On Oct. 1, 20007, the HAC provisions required hospitals to begin reporting on their Medicare claims, whether specified diagnoses were present when the patient was admitted.

The first eight conditions selected last were: object inadvertently left in after surgery; air embolism; blood incompatibility; catheter-associated urinary tract infection; pressure ulcer; vascular catheter-associated infection; surgical site infection, such as mediastinitis after coronary artery bypass graft surgery; and certain types of falls and trauma.

CMS is currently proposing to expand the list of conditions to include:

  • Deep vein thrombosis/pulmonary embolism;
  • Surgical site infections following certain elective procedures;
  • Legionnaires' disease;
  • Extreme blood sugar derangement;
  • Iatrogenic pneumothorax;
  • Delirium;
  • Ventilator-associated pneumonia;
  • Staphylococcus aureus septicemia (bloodstream infection); and
  • Clostridium difficile associated disease (a bacterium that causes severe diarrhea).


The second proposed initiative is the expansion of the hospital quality measure reporting program, which reduces the amount a hospital is paid if it does not participate in the voluntary reporting of standardized quality measures.

CMS is accepting comments until June 13.