The Centers for Medicare & Medicaid Services on Feb. 16 issued a proposed rule setting forth policies for prohibiting federal payments to states for any amount paid toward medical assistance for healthcare-acquired conditions, including the current list of Medicare hospital-acquired conditions and preventable, adverse conditions identified by the state and occurring in any health care setting. The rule also authorizes states to identify preventable conditions for which state Medicaid payment would be prohibited, such as wrong site, procedure or patient surgery.
In general, Medicaid state plans must be amended to lay out the rules for reducing provider payment with respect to healthcare-acquired conditions that would otherwise result in an increase in payment. States also must be able to identify the portion of the provider's payment that is directly related to treatment for the healthcare-acquired condition.
State plans must assure that Medicaid beneficiary access to services is maintained. The rule will be published in the Feb. 17th Federal Register, with comments accepted for 30 days.
[ via AHA News Now ]
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