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Non-payment for Health-care Associated Infections

SECTION 16.   (A) The definition of "Facility" in subsection (a) of section 51H of chapter 111 of the General Laws, inserted by section 9 of chapter 305 of the acts of 2008, is hereby amended by striking out the figure "25" and inserting in place thereof the following figure:- 25B.

(B) Said section 51H of said chapter 111 , as so inserted, is hereby further amended by striking out subsection (d) and inserting in place thereof the following subsection:-
          (d) The department shall adopt regulations prohibiting a health care facility from charging or seeking reimbursement for services provided as a result of the occurrence of a health-care associated infection or serious reportable event. A health care facility shall not charge or seek reimbursement for a health-care associated infection or serious reportable event that the facility has determined, through a documented review process, and under regulations adopted by the department, was (i) preventable; (ii) within its control; and (iii) unambiguously the result of a system failure based on the health care provider's policies and procedures.

(C) Said section 51H of said chapter 111, as amended by section 65 of chapter 451 of the acts of 2008, is hereby further amended by striking out subsection (d) and inserting in place thereof the following subsection:-
          (d) The department shall adopt regulations prohibiting a health care facility from charging or seeking reimbursement for services provided as a result of the occurrence of a health-care associated infection or serious reportable event. A health care facility shall not charge or seek reimbursement for a health-care associated infection or serious reportable event that the facility has determined, through a documented review process, and under regulations adopted by the department, was (i) preventable; (ii) within its control; and (iii) unambiguously the result of a system failure based on the health care provider's policies and procedures.

(D) Subsection (C) shall take effect on October 1, 2012.
 
 

Summary:
This section requires that the Department of Public Health regulations, already required to prohibit health care facilities from seeking reimbursement for serious reportable events, also prohibit reimbursement for health care associated infections.