CMS: No Medicaid Pay for HACs

The final rule is effective July 1, 2011 but gives States the option to implement between its effective date and July 1, 2012.

The following is a list of the Medicare HACs for FY 2011 (75 FR 50084 through 50085):

– Foreign Object Retained After Surgery.

– Air Embolism.

– Blood Incompatibility.

– Stage III and IV Pressure Ulcers.

– Falls and Trauma.

+ Fractures.
+ Dislocations.
+ Intracranial Injuries. 
+ Crushing Injuries.
+ Burns. 
+ Electric Shock.

– Manifestations of Poor Glycemic Control.

+ Diabetic Ketoacidosis. 
+ Nonketotic Hyperosmolar Coma. 
+ Hypoglycemic Coma.
+ Secondary Diabetes with Ketoacidosis.
+ Secondary Diabetes with Hyperosmolarity.

– Catheter-Associated Urinary Tract Infection (UTI).

– Vascular Catheter-Associated Infection.

– Surgical Site Infection Following:

+ Coronary Artery Bypass Graft (CABG) –

– Mediastinitis.

+ Bariatric Surgery.

– Laparoscopic Gastric Bypass.

– Gastroenterostomy.

– Laparoscopic Gastric Restrictive Surgery.

+ Orthopedic Procedures.

– Spine.
– Neck.
– Shoulder.
– Elbow.

– Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE).

+ Total Knee Replacement.
+ Hip Replacement.

The Secretary may revise this list upon review and does so through notice and comment rulemaking, according to the Final Rule.