Proposed rule includes provisions implementing ACA’s PSO reporting requirements
The Department of Health and Human Services (HHS) issued a
proposed rule implementing a number of provisions of the
Affordable Care Act (ACA), including the provision that hospitals
must satisfy certain patient safety and quality improvement
requirements in order to contract with a qualified health plan
(QHP) through the new health insurance exchange (in California,
that is Covered
Beginning Jan. 1, 2017, QHPs may contract with hospitals that
have more than 50 beds only if they meet certain patient safety
standards, including the use of a patient safety evaluation
system (PSES) and a comprehensive hospital discharge program. The
proposed rule clarifies the PSES provision, defining a PSES as
the collection, management or analysis of information for
reporting to or by a patient safety organization (PSO). The
Centers for Medicare & Medicaid Services (CMS) proposes to phase
in these changes, noting the challenges in meeting the condensed
timelines. In phase one, CMS proposes that a QHP insurer may
contract with hospitals that have more than 50 beds only if they
are either Medicare-certified (having a Medicare CCN) or are
Medicaid-only and have been issued a Medicaid-only CCN.
Both types of hospitals are subject to the Medicare Conditions of
Participation. More specifically, CMS notes the importance of
hospitals having a robust quality assessment and performance
improvement program (42 CFR §482.21), as well as an effective
discharge planning process that applies to all patients (42 CFR.
§43). Under the current proposal, phase one would last two years
or until CMS issues further regulation.
CMS also requests comments on how QHP issuers could track
hospital membership in PSOs and other patient safety information,
and which specific comparable activities could be included as
reasonable exceptions to the ACA’s specific patient safety
standards. Comments on the proposed rule are due by Dec. 26.
Please contact email@example.com
with any comments.
CHPSO members gain extraordinary access to incident data analysis
and the collective intelligence of patient safety experts
nationwide. We maintain close alliances with other national PSOs,
quality and safety agencies, research institutes and think tanks.
This translates into exponential improvements, economically and
Membership is offered at no charge for members of the California
Hospital Association and the Regional Hospital Associations.
Membership is also available to hospitals outside of California
for a nominal fee. Further information is on our web site.