Medicare HAC Penalties Increase Over Last Year

By Jill Drachenberg, AHC Media Managing Editor

Medicare will penalize 758 hospitals by docking reimbursement 1% in fiscal year 2016 under the Hospital-Acquired Condition (HAC) Reduction Program, up from 724 hospitals last year.

Moreover, 54% of the hospitals penalized last year are also being hit in this latest round of penalties. The data released by the Centers for Medicare & Medicaid Services (CMS) on Thursday shows that hospitals will lose a combined $364 million in reimbursements. Critical access hospitals, children’s hospitals, and veterans hospitals are exempt.

CMS looked at the frequency of central line-associated bloodstream infections, catheter-associated urinary tract infections, and infections from colon surgeries and hysterectomies between 2013 and 2014. As reported in a previous reliasmedia.com article, a new Agency for Healthcare Research and Quality (AHRQ) report shows that HAC rates from 2013-2014 held steady and did not decline.

There has been much criticism of the HAC Reduction Program over the years, particularly because CMS requires one-quarter of hospitals to be penalized each year. Other hospitals say that the program takes older data into account, and does not adjust for hospitals that serve older, sicker patient populations at higher risk for infections and other adverse outcomes.