The CMS issued its final rule (PDF) ending federal Medicaid payments for a list of specified healthcare-acquired conditions, such as late-stage pressure ulcers and foreign objects retained after surgery.
CMS issues final rule ending Medicaid payments for HACs
Twenty-one states already have some form of nonpayment policy for preventable healthcare-acquired conditions, and many of them use Medicare's current list of HACs, according to the rule. But other states' HAC lists differ from the one used by the Medicare program.
In order to preserve state-by-state flexibility, the final rule, which goes into effect July 1, requires states to recognize, at a minimum, Medicare's current HAC list, but it also allows states to “continue to enact more stringent laws or regulations,” based on the agency's approval.
The CMS predicted the rule will result in significant cost savings and will also motivate providers to improve quality practices at their facilities.
“We anticipate that these provisions will prompt healthcare providers to adopt quality programs that would limit the risk of providing services or using resources, in error, that will not be reimbursed,” the agency said in the final rule.
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