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August 24, 20071. Medicare Will Not Reimburse Hospitals for Preventable Errors 2. HHS Accepting Nominations for ‘Healthy People’ Advisory Committee 1. Medicare Will Not Reimburse Hospitals for Preventable Errors The Centers for Medicare & Medicaid Services (CMS) released a new rule August 22, 2007, stating Medicare will no longer reimburse hospitals for costs associated with treating preventable medical errors that a patient acquires while at the hospital. According to Bush administration officials, this significant policy change, initially proposed by CMS in April 2007, “aims to save lives and millions of dollars.” A provision required by the Deficit Reduction Act of 2005 (PL 109-171), the final rule will take effect October 2008. According to the new rules, Medicare will no longer cover the costs of treatment for eight conditions:
The last three conditions listed are described as serious preventable events, often called “never events.” CMS officials plan to add three additional conditions to the list by 2008. The new rule was met with mixed reviews by members of the health care industry. Some observers hail the rule for its potential to force physicians to adhere strictly to clinical guidelines and assess the conditions with which patients arrive at the hospital; however, hospital executives worry that the rule will spike the number of tests patients receive at admission and increase overall costs for the hospital. In addition, observers worry about the displacement of costs that hospitals incur should the need to treat a preventable medical error arise. Under the new rule, “the hospital cannot bill the beneficiary for any charges associated with the hospital-acquired complication.” The rule is not meant to relieve hospitals of the obligation to treat preventable conditions. Regarding the concern that a hospital will avoid patients that are at high risk of complications, CMS notes that “the policy is selecting only those conditions that are ‘reasonably preventable.’ Thus, we are only selecting those conditions where, if hospital personnel are engaging in good medical practice, the additional costs of the hospital-acquired condition will, in most cases, be avoided and the risk of selectively avoiding patients at high risk of complications will be minimized.” American Hospital Association Vice President Nancy E. Foster commented on the inability to prevent some of the conditions that Medicare has listed even if proper care is provided. Citing the development of pressure ulcers—one of the conditions on Medicare’s list—Ms. Foster stated, “Certain patients, including those at the end of life, may be exceptionally prone to developing pressure ulcers, despite receiving appropriate care.” This worry seems to have little effect on private insurers who have expressed interest in adopting similar policies. 2. HHS Accepting Nominations for ‘Healthy People’ Advisory Committee The US Department of Health and Human Services (HHS) is now accepting nominations for members of the Secretary’s Advisory Committee on National Health and Disease Prevention Objectives for 2020. According to HHS, the selected committee members will be charged with providing “advice and assistance to the Secretary and HHS in the development of health promotion and disease prevention objectives to improve the health of Americans by 2020.” The public health objectives, known as “Healthy People,” have been published every decade since 1979, and are “grounded in the notion that setting objectives and monitoring progress can motivate action.” Nominations may be sent to HHS via email at HP2020@hhs.gov or standard mail. Nominations are due by September 20, 2007. Selected committee members will have a working knowledge of current health promotion, disease prevention, and public health research. They will be familiar with Healthy People or similar public health benchmarks and have demonstrated an interest in public health and well-being through their education, research, or patient care missions. HHS is particularly interested in identifying individuals with expertise in a number of policy areas including, but not limited to, health policy, state and local public health, business, outcomes research, health economics, health communications, special populations, biostatistics, international health, and epidemiology. Applications must include:
The committee will meet at least once a year, starting in December 2007. Committee members are expected to assist HHS in preparing public health objectives that are “scientifically valid, relevant, and sustainable.” For additional information on the committee, nomination process, or Healthy People, please visit the Healthy People website. If there is interest from the membership, the Alliance for Academic Internal Medicine will nominate a member of the alliance to serve on the committee. Interested candidates should contact Policy@im.org by Friday, September 7, 2007. The Alliance for Academic Internal Medicine—the nation’s largest academically focused specialty organization—consists of the Association of Professors of Medicine, the Association of Program Directors in Internal Medicine, the Association of Subspecialty Professors, the Clerkship Directors in Internal Medicine, and the Administrators of Internal Medicine. Please contact AAIM Vice President for Policy Charles P. Clayton (cclayton@im.org), AAIM Policy Associate Nicole V. Baptista (nbaptista@im.org), or AAIM Policy Assistant Allison L. Haupt (ahaupt@im.org) at (202) 861-9351 with questions or comments about this week’s Merlin. |
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