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CMS expands list of no-pay conditions to 11

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Modern Health reports that CMS has added three additional hospital-acquired conditions for which Medicare will no longer reimburse beginning Oct. 1, bringing that total to 11. The agency also will require hospitals to report on 13 more quality measures under the inpatient prospective payment system 2009 final rule announced this afternoon.

As previously blogged, hospitals were originally to stop receiving payment for eight conditions, a mix of hospital-acquired infections and National Quality Forum-endorsed “never events,” but the final rule brought that number up to 11.

Following on from the earlier CMS ruling, the American Hospital Association and many state hospital associations have adopted guidelines for voluntary discounting or waiving of payment for care associated with serious, adverse events. Private insurers are also moving towards not paying for care associated with preventable events. Read more on this topic.

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