AHA News: The Centers for Medicare & Medicaid Services is encouraging states to coordinate their Medicaid payment policies with Medicare’s hospital-acquired condition payment policy to ensure that states do not pay for serious adverse events. With the inclusion of two additional conditions in its fiscal year 2009 inpatient prospective payment system final rule, beginning Oct. 1, CMS will no longer pay hospitals a higher diagnosis-related group rate for 10 conditions if they were not reported as present on admission. In a July 31 letter to state Medicaid directors, CMS pointed out that many Medicare beneficiaries are dual-eligible for Medicaid. As a result, states wishing to avoid Medicaid payment liability for the costs of serious adverse events no longer paid for by Medicare may choose to alter their Medicaid state plans to also deny payment for serious adverse events.
CMS seeks coordination of serious adverse event payment policies
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