News You Can Use: Does Your JCAHO Score Measure Up?

Future Medicare eligibility could hinge on it

Expect JCAHO survey results to weigh heavier
A scathing report by the General Accounting Office (GAO) may signal changes in the way hospitals are granted eligibility for Medicare payments.
Prior to 2004, of the hospitals found by state survey agencies to have deficiencies in Medicare requirements, 78 percent went undetected by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), according to the report (GAO-04-850). Some of the problems in accredited hospitals included a lack of procedures to prevent the spread of infections, protect against fire-related disasters, and ensure overall satisfactory performance of both physicians and nurses.
The GAO recommended that CMS, not the JCAHO, be given statutory authority over the hospital assessment process - a move that would reverse a 40-year tradition. Rep. Pete Stark (D-Calif.) and Sen. Charles Grassley (R-Iowa), who requested the study, wasted no time unfurling legislation with similar language. As an example of a "worst-case scenario," Grassley said that prior to a recent fraud bust, Tenet's Redding, Calif., hospital had "boasted about high scores from the Joint Commission." The facility was subsequently charged with performing hundreds of medically unnecessary cardiac procedures on patients.
 
JCAHO, which did not oppose the change, fired back at the GAO's conclusions, which it said were "based upon a flawed study methodology and erroneous, alarming statistics that seriously mislead the public and do a great disservice to the Commission." JCAHO also said it had not sought nor was aware of its unique statutory authority to accredit hospitals.
Submit undocumented alien info, win fabulous prizes
The Centers for Medicare and Medicaid Services (CMS) is dangling a new carrot in front of providers - but will it put you between a rock and a hard place with your uninsured patients? The new proposal, issued July 22, would make $250 million a year ($1 billion total over four years) available to hospitals and providers to "help recoup the costs of providing uninsured care," according to CMS.
Nestled in the proposal is a requirement that hospitals and others collect and maintain additional information on the immigration status of patients in order to receive the additional federal payments. One-third of the money, which was earmarked by the Medicare Modernization Act, would go to those states with the largest number of apprehensions of undocumented aliens.
Now, aliens who are eligible for "emergency only" Medicaid coverage are not required to provide proof of immigration status. Participants at an Open Door Listening Session in March 2004 raised concerns that inquiries about patients' citizenship would deter many from coming through emergency-department doors, CMS said.
But the agency cites a May 2004 General Accounting Office report (GAO-04-472) which found that a [...]

- Published on 2004-08-23