Friday, December 5, 2008

"Never Events" (HACs) and Maryland Hospitals

Good morning and welcome to everyone who has taken a look at the first blog efforts here --

At Denise's request, I talked a little about the new Medicare regulations that would prevent hospitals from receiving payment for treating "Hospital Acquired Conditions" that should never have occurred.

Several of you informed me that Maryland hospitals have their own Medicare payment system and asked whether the HAC rules applied. The answer is no: "Maryland Waiver Hospitals" are exempt from reporting the "Present On Admission" or POA indicators on their claims, and the "CMS Standard system ... will know not to apply the HAC DRG logic to these claims." This is all spelled out in CMS' Transmittal 354, dated June 13, 2008, instructing the carriers on how to handle "Hospitals Exempt from POA Reporting." If all goes well, you will find a working link to this Transmittal above this message.

Last Monday's e-blast Alert from my boss, Tony Mira (ABC) gave an introduction to the HAC regulations. If you would like a copy, and/or to subscribe to the distribution list for those Monday Alerts and for the ABC Communique, please contact cortney.shepherd@anesthesiallc.com.

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Thank you--

Karin

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