MO HealthNet Regulation on Adverse Events
The rule ensures that state Medicaid policies dovetail with new federal Medicare policies for nonpayment of certain adverse events and HACs.
This spring, a new MO HealthNet payment policy was finalized on preventable serious adverse events and errors in medical care that are clearly identifiable, preventable and serious in their consequences. This rule affects services provided by acute care hospitals and ambulatory surgical centers that are MO HealthNet providers.
The rule, 13 CSR 70-15.200 Payment Policy for Preventable Serious Adverse Events, was developed by the Missouri Department of Social Services. It was based on the recommendation from the Centers for Medicare & Medicaid Services to ensure that state Medicaid policies dovetail with new Medicare policies from CMS for nonpayment of certain adverse events and hospital-acquired conditions.
The rule requires MO HealthNet hospitals and ASCs to have a contract with a federally-designated patient safety organization, such as the Missouri Center for Patient Safety, by January 1, 2010. MHA has provided funding to the MOCPS since its inception and recently increased its support to allow MHA-member hospitals to receive standard PSO services at no cost.
For your reference, the following information is available to assist your hospital with rule compliance.
In addition, complete the follow-up form from the Missouri Center for Patient Safety to learn how its staff can assist you in complying with the regulation.
For more information about the mandated reporting, please contact Sharon Burnett or Steve Renne.
DISCLAIMER NOTE
This toolkit should be used as one of many resources in maintaining compliance with the requirements outlined in 13 CSR 70-15.200. The actual regulation is the best source of information. The toolkit is not meant to interpret regulations but to compliment your review of the actual regulation. Ultimately, the MO HealthNet Division of the Missouri Department of Social Services is responsible for interpreting and enforcing the regulation.
Information in this toolkit is provided with the understanding that the Missouri Hospital Association is not rendering legal or other professional advice and services. Although MHA has made every attempt to ensure that the information contained in these materials is generally useful for its intended purposes, MHA and its subsidiaries, affiliates, agents and employees are not responsible for any errors or omissions or for the results obtained through use of these tools.
Portions of the Missouri Code of State Regulations are included in this document. The Missouri Code of State Regulations is an official state publication under authority granted to the Missouri secretary of state's office pursuant to §§536.015 and 536.031, RSMo. Reproduction of the regulations is allowed. However, no reproduction shall bear the name "Code of State Regulations" or "official" without the express written permission of the secretary of state's office.
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