For example, if you are a senior on Medicare, and come down with MRSA during your stay at the hospital for something that is covered by Medicare, there will usually be extra costs incurred for the additional treatment needed. However, this additional cost will not be paid by Medicare. The bill will be paid for by the hospital since the new rules will not allow the hospital to make you pay the charges.
The new rule is designed to improve the accuracy of Medicare’s payment for patients under the acute care hospital inpatient prospective payment system. It is also designed to encourage hospitals to improve their quality control.
This means that Medicare will not pay for major mistakes like surgical objects left in a patient after a surgery or a patient that receives the wrong blood type during a transfusion. But the area most impacted by the new rule will be in hospital acquired infections like MRSA. Infections like MRSA kill around 100,000 Americans each year, and another 2 million require treatment. The idea is that it will give hospitals a reason to use more caution in preventing these mistakes since they will be footing the bill themselves.
Every year, many people suffer because of infections and errors that could have been prevented. The new rules allow Medicare to use its power to encourage hospitals to keep their patients safe and improve their care.
At the moment, over half of the treatments for hospital acquired infections are paid by Medicare. A good portion of these infections could have been prevented with infection control procedures like proper hand washing between patients.
These new rules are able to be put in affect because of the Deficit Reduction Act of 2005. Under this Act, hospitals will have to start reporting these secondary infections and diagnoses starting October 1, 2007. This will start the change over, and as of the new financial year in 2009 Medicare will not pay for the treatment of these diagnoses unless they were present when the patient was admitted to the hospital.
There are certain conditions that will no longer be covered by Medicare. These include: mediastinitis after coronary artery bypass graft surgery, bed sores, air embolisms, falls, objects left in a patient after surgery, and different catheter-associated infections.
Another change due to the new rules will be the lists of publicly reported quality measures and the amount of payment Medicare will pay out for devices that the hospitals replace.
The new rules should improve the quality of care for hospital patients, and at the same time save taxpayers millions of dollars. Currently, Medicare pays over $400 billion dollars each year, and this number is expected to rise as the baby boomers continue to age.
