Federal Reporting

 

To keep up to date with the latest information from the Centers for Medicare & Medicaid Services (CMS) regarding "Reporting" of the Hospital-acquired Conditions (HAC) & Present on Admission (POA) Indicators visit the CMS website.

 

The CMS website includes an overview of the statute; conditions for October 1, 2008 implementation, conditions being considered for 2009, and finally, conditions needing further analysis.  It also contains a section with educational resources which includes downloadable documents e.g. Hospital-acquired Conditions in Acute Inpatient Prospective Payment System (IPPS) Hospitals and a number of audio presentations.

 

Important Implementation Dates
  • October 1, 2007
    All IPPS Hospitals were required to submit POA Indicator information for all primary and secondary diagnoses.
  • January 1, 2008
    CMS began processing POA Indicator data and provided feedback to IPPS hospitals on reporting errors. During the period of January 1, – March 31, 2008 hospitals were educated on reporting errors and were NOT be subject to returned claims.
  • April 1, 2008
    Claims that were submitted for payment that did not contain proper reporting of the POA Indicator were returned.

 

State Reporting

 

The following is a summary of state activity and legislation regarding the disclosure by hospitals of their hospital infection rates.

 

As of June 15, 2008:

  • 22 states have laws requiring public reporting of infection rates (CO, CT, DE, FL, IL, MD, MN, MO, NJ, NY, NH, OH, OK, OR, PA, SC, TN,TX, VA, VT, WA, WV);
  • 2 state laws require public reporting of infection information, but not specifically infection rates (CA, RI).
  • 2 state laws require confidential reporting of infection rates to state agencies (NE, NV).
  • 1 state law permits voluntary public reporting of infection information (AR).
  • All other states except WY, AZ, MT, ND have considered hospital infection reporting laws, but have not yet passed legislation.
    Click here for further updates

 

Here is an example of how an individual state is handling their cost reporting.

The Pennsylvania Health Care Cost Containment Council is an independent state agency responsible for addressing the problem of escalating health costs, ensuring the quality of healthcare, and increasing access for all citizens regardless of ability to pay.  The website is a good source of data (2005) regarding number of cases of HAI, the average length of stay, and related costs.

 

  • According to Pennsylvania Health Care Cost Containment Council, the average payment for a hospitalization in which a patient acquired an infection was $53,915, while the payment when a hospital-acquired infection was not present averaged $8,311.  The differences in payment varied by the condition that brought a patient to the hospital.


Related Links:

 

Reimbursement Hotline
Questions about reimbursement?

 

To keep up to date with reimbursement issues, we offer a toll-free reimbursement hotline

 

The Joint Commission

The Joint Commission's goal is to continuously improve the safety and quality of care provided to the public through the provision of healthcare accreditation and related services that support performance improvement in healthcare organizations.

 

Institute of Healthcare Improvement
5 Million Lives Campaign

The 5 Million Lives Campaign is a voluntary initiative to protect patients from five million incidents of medical harm over the next two years (December 2006 – December 2008).


Other Resources: