CMS rule on three hospital-acquired.

On July 31, the Centers for Medicare & Medicaid Services (CMS) added three new "hospital-acquired conditions" (HACs), in the final rule for the Medicare acute care inpatient prospective payment system (IPPS):

* Surgical site infections following certain elective procedures, including certain orthopedic surgeries, and bariatric surgery for obesity;

* Certain manifestations of poor control of blood sugar levels; and

* Deep vein thrombosis or pulmonary embolism following total knee replacement and hip replacement procedures.

These conditions will incur a lower Medicare reimbursement rate unless patient records show the condition was "present on admission" (POA). The eight previously selected HACs are: object left in surgery; air embolism; blood incompatibility; catheter-associated urinary tract infection; pressure ulcers; vascular catheter-associated infection; surgical site infection--mediastinitis after CABG (coronary artery bypass graft); and falls (and additional injuries). Hospitals began reporting on these in October 2007, for payments starting October 2008. ANA has provided comments to CMS on HACs and POA reporting, and all ANA comments will soon be available on Nursing World under Government Affairs/Regulatory Affairs. More information about this decision can be found at www.cms.hhs.gov/HospitalAcqCond <http://www.cms.hhs.gov/HospitalAcqCond/

Edited from the ANA Government Affairs--Janet Haebler MSN RN, Associate Director, State Government Affairs.