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Consumers Union Supports Proposed Expansion of Medicare Policy to Withhold Payments to Hospitals That Harm Patients
Date:6/19/2008

infections: serious bed sores, objects left in patients' bodies following surgery, blood incompatibility, and air embolism. These rules will go into effect on October 1.

Under the proposed regulations for 2009, Medicare would expand this policy by withholding payments to hospitals for the extra care associated with treating certain surgical site infections (specifically for total knee replacement, laparascopic gastric bypass and gastroeneterostomoy, and ligation and stripping of varicose veins); Legionnaires' disease (a type of pneumonia caused by a specific bacterium); extreme blood sugar derangement; Iatrogenic pneumothorax (collapse of the lung) delirium; ventilator-associated pneumonia; deep vein thrombosis/pulmonary embolism (formation/movement of a blood clot); staphylococcus aureus septicemia (bloodstream infection); and Clostridium difficile associated disease (a bacterium that causes severe diarrhea and more serious intestinal conditions such as colitis).

"Taxpayers spend billions of dollars every year covering the cost of preventable hospital errors and infections," said McGiffert. "Restricting Medicare payments for these hospital acquired conditions will help ensure that taxpayer dollars pay for safer and more effective health care."

Consumers Union urged CMS to expand its current proposal by adding two more hospital acquired infections to the nonpayment list: Methicillin-resistant Staphylococcus aureus (MRSA) infections, and infections associated with hip replacement surgery.

Consumers Union also recommended adding preventable readmissions to the non-payment policy. The Medicare Payment Advisory Commission found that almost 18 percent of Medicare hospital patients were readmitted within 30 days of discharge, at a cost of $15 billion to Medicare. The Commission concluded that 76 percent of readmissions after 30 days are preventable. Finally, Consumers Union urged CMS to add a disclosure component to the non-payment policy so t
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SOURCE Consumers Union
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