AMA, AAMC Oppose Proposed Additions to No-Pay Healthcare-Acquired Conditions

The American Medical Association and the Association of American Medical Colleges expressed opposition to provisions under CMS' proposed rule for the FY 2013 Inpatient Prospective Payment System that would expand the list of hospital-acquired conditions Medicare will not reimburse, according to an American Medical News report.

The proposed rule, which was released in late April, includes a recommendation to add two new conditions to the hospital-acquired condition payment provision list. The list currently includes 10 conditions that are high-cost, high-volume or both and could have been prevented through evidence-based measures. Hospitals that fail to prevent these conditions are subject to payment cuts.

 



The two proposed conditions are surgical site infection following cardiac implantable electronic device procedures and pneumothorax with venous catheterization

In a letter to CMS, the AMA argued the conditions are not always preventable and the policy unfairly subjects providers to non-payment. Meanwhile, AAMC said the additional measures are "an unnecessary duplication," as they are already or are proposed to be a part of the hospital value-based purchasing program.

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