Consumers Union Supports Proposed Expansion of Medicare Policy to Withhold Payments...

Consumers Union Supports Proposed Expansion of Medicare Policy to Withhold
Payments to Hospitals That Harm Patients

Non-Payment Plan Aims to Reduce Preventable Hospital Acquired Infections &
Medical Errors

WASHINGTON, June 19 /PRNewswire-USNewswire/ -- The federal government should
expand its effort to restrict Medicare payments to hospitals for the cost of
health care associated with certain infections and medical errors acquired
during treatment, according to Consumers Union, the nonprofit publisher of
Consumer Reports.

Last year, the Centers for Medicare and Medicaid Services (CMS) adopted new
rules that will end payments to hospitals for the extra care required to treat
patients harmed by certain preventable hospital acquired conditions. Now the
agency has proposed expanding the list of preventable conditions covered by
the non-payment rules.

In comments submitted to the Centers for Medicare and Medicaid Services (CMS),
Consumers Union said that a proposal by the agency to limit such payments
would provide hospitals with a strong new financial incentive to improve
patient care. Consumers Union urged CMS to strengthen the proposed
regulations by expanding the types of preventable hospital acquired conditions
that would result in lower Medicare payments and to clarify protections to
ensure patients are treated fairly and get the care they need.

"By restricting payment for preventable medical errors and hospital acquired
infections, Medicare is sending a powerful message to hospitals that harming
patients will harm their bottom line," said Lisa McGiffert, Director of
Consumers Union's Stop Hospital Infection's campaign
(www.StopHospitalInfections.org). "This effort will ultimately save money and
lives by motivating hospitals to follow long-standing patient safety practices
that are too often ignored."

The nonpayment rules adopted by CMS last year cover certain urinary tract
infections, staph aureaus bloodstream infections, and four other hospital
errors unrelated to infections: serious bed sores, objects left in patients'
bodies following surgery, blood incompatibility, and air embolism. These
rules will go into effect on October 1.
Under the proposed regulations for 2009, Medicare would expand this policy by
withholding payments to hospitals for the extra care associated with treating
certain surgical site infections (specifically for total knee replacement,
laparascopic gastric bypass and gastroeneterostomoy, and ligation and
stripping of varicose veins); 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); and Clostridium
difficile associated disease (a bacterium that causes severe diarrhea and more
serious intestinal conditions such as colitis).
"Taxpayers spend billions of dollars every year covering the cost of
preventable hospital errors and infections," said McGiffert. "Restricting
Medicare payments for these hospital acquired conditions will help ensure that
taxpayer dollars pay for safer and more effective health care."

Consumers Union urged CMS to expand its current proposal by adding two more
hospital acquired infections to the nonpayment list: Methicillin-resistant
Staphylococcus aureus (MRSA) infections, and infections associated with hip
replacement surgery.

Consumers Union also recommended adding preventable readmissions to the
non-payment policy. The Medicare Payment Advisory Commission found that
almost 18 percent of Medicare hospital patients were readmitted within 30 days
of discharge, at a cost of $15 billion to Medicare. The Commission concluded
that 76 percent of readmissions after 30 days are preventable. Finally,
Consumers Union urged CMS to add a disclosure component to the non-payment
policy so that the public could find out which hospitals are having payments
withheld because of preventable harm to patients.

When CMS adopted the initial non-payment rules last year, it included
protections to prevent hospitals from billing patients when Medicare payments
are withheld, and to prohibit hospitals from avoiding patients perceived to be
at risk for infections. But Consumers Union raised concerns that these
protections remain vague and should be clarified to ensure patients harmed by
hospital acquired conditions aren't billed for the extra care associated with
treating them.

"We remain concerned that there are no details regarding how Medicare intends
to monitor and respond to patients who are unfairly billed or unfairly treated
in these situations," said McGiffert. "Medicare should develop an expedited
review process for claims from patients who have been harmed by their medical
care."

A copy of Consumers Union's comment letter to CMS is available at:
http://www.consumersunion.org/campaigns/stophospitalinfections/learn.html

Consumers Union, publisher of Consumer Reports, is an independent, nonprofit
testing and information organization serving only the consumer. We are a
comprehensive source of unbiased advice about products and services, personal
finance, health, nutrition, and other consumer concerns. Since 1936, our
mission has been to test products, inform the public, and protect consumers.
www.StopHospitalInfections.org, a project of Consumers Union, advocates for
public disclosure of hospital-acquired infection rates.

SOURCE Consumers Union

Lisa McGiffert, +1-512-477-4431, ext 115, or Michael McCauley,
+1-415-431-6747, ext 126, both of Consumers Union