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CMS Medicaid Rule Could Place Additional Pressure On Hospitals To Reduce Preventable Errors

Armen Hareyan's picture

CMS Medicaid Rule

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The Philadelphia Inquirer on Thursday examined a new rule from CMSthat will deny reimbursements to hospitals for preventable conditionsthat develop while patients are in their care, effective Oct. 1, 2008.According to the Inquirer, the goal "is not to punish hospitals but to spur action to improve patient safety."

StateMedicaid programs also might adopt the CMS changes. For example,Pennsylvania's Medicaid program has plans to adopt the rule and toexpand the number of preventable errors for which it will notreimburse, as part of Gov. Ed Rendell's (D) "Prescription for Pennsylvania" health care reform proposalannounced in January. The "financial power of Medicare plus the addedinfluence of state Medicaid spending are likely to propel progress inthe fight against medical errors," and the hospital industry "haslittle choice but to join the effort," according to the Inquirer.

"Hospitalsbelieve that these are reasonable approaches and that for things thatwere truly preventable there should not be an additional payment,"Paula Bussard, senior vice president for policy at the Hospital and HealthSystem Association of Pennsylvania, said (Goldstein, Philadelphia Inquirer, 8/30).

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