CMS Changes for Infection Control Linked to Hospital Reinbursement

The US Centers for Medicare and Medicaid Services (CMS), on July 30, released it’s final rule for fiscal year 2011 Hospital Inpatient Prospective Payment System (IPPS).  This is the first time ALL HOSPITALS participating in the Medicare program must report data on specific HAIs, which are limited to Central Line Associated Bloodstream Infections (CLABSIs) and Surgical Site Infections (SSI), through the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN).  Reporting requirements in this final rul include:

  • Central line-associated bloodstream infections (CLABSI): Data collection will begin with January 1, 2011 discharges for Medicare payment beginning in FY 2013.
  • Surgical site infections (as yet unspecified):  Data collection will begin with January 2, 2012 discharges for Medicare payment beginning in FY 2014

Hospitals that do not submit CLABSI and SSI data per the final rule are eligible to continue to participate in the Medicare program, but will be subject to a reduction in their Medicare Annual Payment Update.  As with other quality measures, CLABSIs, SSIs, and any HAIs that may be added in the future will be publicly reported on the CMS Hospital Compare website. (www.hospitalcompare.hhs.gov)

The required use of NHSN reflects an important step toward replacing the reliance on administrative (or “coding”) data with clinical information. 

For hospitals not currently participating in NHSN, the upcoming months will be critical as they prepare to submit data.  To help both new and existing NHSN users, CMS and CDC are working togeteher to improve user support and training materials.  Hospitals not enrolled in NHSN can learn more at the CDC NHSN website. (www.cdc.gov/nhsn)

To obtain a copy of this final rule go to: www.ofr.gov

If your hospital needs assistance in preparing for this upcoming change contact InCo and Associates International.

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