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Non-Payment For Medical Errors: What You Need To Know.

Publication: Mondaq Business Briefing
Publication Date: 11-MAR-08 		Format: Online
Delivery: Immediate Online Access

Article Excerpt
Are pressure ulcers always preventable? How about urinary tract infections (UTI)? If a hospital-acquired infection (HAI) is present, should payment be denied in whole or in part? These are the kinds of questions Medicare has had to field as it developed its new inpatient prospective payment rule, to become effective later this year, to eliminate payment for certain HAIs. For discharges on and after October 1, 2008, hospitals will not receive payment for eight selected conditions:

Object left in surgery,

Air embolism,

Blood incompatibility,

Catheter-associated urinary tract infections,

Pressure ulcers (decubitus ulcers),

Vascular catheter-associated infections,

Surgical site infections - mediastinitis after coronary artery bypass graft, and

Hospital-acquired injuries - fractures, dislocations, intracranial injuries, crushing injuries, burns, and other unspecified effects of external causes.

The conditions selected for non-payment (a) are high cost or high volume or both, (b) will result in the...

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