APIC to Review HAI Data-Reporting Mandates from CMS

The Association for Professionals in Infection Control and Epidemiology (APIC) reminds its members that on July 30, the Centers for Medicare and Medicaid Services (CMS) released its final rule for the FY 2011 Hospital Inpatient Prospective Payment System (IPPS) and explains that this is the first time that all hospitals participating in the Medicare program must report data on specific healthcare-acquired infections (HAIs), which are limited to central line-associated bloodstream infections (CLABSIs) and surgical site infections (SSIs), through the Centers for Disease Control and Prevention (CDC)'s National Healthcare Safety Network (NHSN). Reporting requirements in this final rule include:

-- CLABSI: Data collection will begin with Jan. 1, 2011 discharges for Medicare payment beginning in FY 2013

-- SSI: (as yet unspecified): Data collection will begin with Jan. 2, 2012 discharges for Medicare payment beginning in FY 2014

APIC says that hospitals that do not submit CLABSI and SSI data per the final rule are eligible to continue to participate in the Medicare program, but will be subject to a reduction in their Medicare Annual Payment Update. As with other quality measures, CLABSIs, SSIs, and any HAIs that may be added in the future will be publicly reported on the CMS Hospital Compare Web site.

The required use of NHSN reflects an important step toward replacing the reliance on administrative (or "coding") data with clinical information. As studies have shown and infection preventionists recognize, the use of administrative data is an unreliable source to measure both the incidence of HAIs and the impact of prevention programs. APIC says it has been a long-standing champion of using clinical data, including submission through NHSN.

For hospitals not currently participating in NHSN, the upcoming months will be critical as they prepare to submit data. To help both new and existing NHSN users, CMS and CDC are working together to improve user support and training materials. Hospitals not enrolled in NHSN can learn more at the CDC NHSN Web site. To help members understand and implement the new IPPS final rule, APIC will be conducing a Webinar in mid-August featuring speakers from the CDC and CMS to clarify the new HAI reporting and payment requirements; APIC will announce details shortly.