CMS proposes nine new HACs, 43 new quality measures

The Centers for Medicare and Medicaid Services (CMS) announced a proposal to add nine conditions to the list of Hospital Acquired Conditions (HACs) for which it will not reimburse hospitals, and to add 43 conditions to Medicare's quality reporting initiative. The annoucement was part of the Proposed Rule for Medicare's Inpatient Prospective Payment System (IPPS) for fiscal year 2009.

The proposed HACs include:

• Surgical site infections following certain elective procedures
• Legionnaires’ disease (a type of pneumonia caused by a specific bacterium)
• Extreme blood sugar derangement
• Iatrogenic pneumothorax (collapse of the lung)
• Delirium
• Ventilator-associated pneumonia
• Deep vein thrombosis/Pulmonary Embolism (formation/movement of a blood clot)
• Staphylococcus aureus septicemia (bloodstream infection)
• Clostridium difficile associated disease (a bacterium that causes severe diarrhea and more serious intestinal conditions such as colitis)

Acting CMS Administrator Kerry Weems said in a news release that the proposal would further tie Medicare reimbursement to quality of care.

"CMS is taking aggressive actions to ensure that beneficiaries get safe, high quality, and efficient care from their health care providers, and the actions we are announcing today build on our effort. The status of the Medicare Hospital Insurance Trust Fund requires us to find the best solutions to ensure that Medicare stays strong while paying providers appropriately for the care they deliver. The reforms we are proposing in this rule should lead to greater value for Medicare beneficiaries and the Medicare program."