AMA disappointed in HHS decision to add new conditions to hospital no-pay list

For immediate release
July 31, 2008

Statement attributable to:
J. James Rohack, MD
President-elect, American Medical Association

"The federal government's decision today to no longer pay hospitals for care provided for three additional medical conditions acquired in the hospital puts patient care at risk. We are working hard to improve quality and efficiency, but simply not paying for complications or conditions that while regrettable — are not entirely preventable — is not the way to do it. It is unacceptable that this program is being expanded beyond the original eight conditions identified last year for non-payment when the first phase of the program has not even begun.

"In the race to improve health care quality, HHS is confusing events that should never happen in a hospital, like wrong-site surgery, with often unavoidable conditions, like surgical site infections. To be reasonably preventable, there should be solid evidence that by following guidelines, the occurrence of an event can be reduced to zero or near zero. This is not the case for many of the now-banned conditions.

"Focusing on determining whether or not medical conditions exist when the patient enters the hospital will increase Medicare spending on tests and screenings with questionable benefit to patients. A more effective patient safety approach would be to encourage compliance with evidence-based guidelines by health care professionals."

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For more information, please contact:

Brenda L. Craine
Director, AMA Media Relations
(202) 789-7447
Brenda.Craine@ama-assn.org