House Bill Would Deny Payment for Preventable Serious Complications
Legislation mirrors upcoming Medicare policy
The state House of Representatives has overwhelmingly passed a bill that would deny payment to physicians and hospitals for preventable serious complications.
House Bill 2098, the Preventable Serious Adverse Events Act, was approved on a 201-2 vote on April 1, 2008, and will now go before the Senate. Medicare has proposed a similar policy that would go into effect in October 2008.
"Even one preventable serious adverse event is too many. At the same time, we must make sure that any legislation protects both patients and physicians and is not used as vehicle for nonpayment for physicians," said Peter S. Lund, MD, president of the Pennsylvania Medical Society.
The Pennsylvania Medical Society’s Board of Trustees on Feb. 6, 2008, voted to seek to delay the bill until the Centers for Medicare and Medicaid Services (CMS) has published its guidelines. As the Board requested, State Society lobbyists were able to secure approval for an amendment that would delay the bill’s effective date until Medicare’s policy changes in October.
The legislation defines a preventable serious adverse event as one that results in unintended injury or illness; could have been prepared for or anticipated; occurs because of an error or system failure; and results in death, loss of body part, disability, or loss of bodily function lasting more than seven days. According to the bill, a serious adverse event would follow Medicare’s list of serious events, which was published in the Federal Register in August 2007. The list includes:
- Objects left during surgery
- Air embolism
- Blood incompatibility
- Catheter-associated urinary tract infections
- Pressure ulcers
- Vascular catheter-associated infections
- Surgical site infection after coronary artery bypass graft surgery
- Falls
- Ventilator-associated pneumonia
- Staphylococcus aureus septicemia
- Deep vein thrombosis/pulmonary embolism
- Methicillin resistant staphylococcus aureus (MRSA)
- Clostridium difficile
In January 2008, Medicaid announced that it would not pay hospitals for serious adverse events, such as surgery on the wrong body part or death or serious disability from a medication error.
Last Updated: 8/1/2008