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The CMS Reimbursement Rules - Essay Example

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The paper "The CMS Reimbursement Rules" tells us about reimbursement rates for all medical services and equipment covered under Medicare. When a provider accepts an assignment, they agree to accept Medicare-established fees. Providers cannot bill you for the difference…
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The CMS Reimbursement Rules
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Extract of sample "The CMS Reimbursement Rules"

The CMS reimbursement rules for never events associated with the use of inpatient facilities such as catheter-associated urinary tract infections with occurrence of infections that were meant not to happen. According to CMS, the use of UTI is one of the primary causes of infections in healthcare; it affects 600,000 to 1 million patients annually. This high number is in tandem with the wide use of UTIs in hospitals. CMS also claimed “the consequences of a UTI can be devastating, ranging from an additional day of hospital care to death” (Crist, 2010. P.1). Additionally, CMS claimed that UTI is one of the hospital facilities that have a very large financial impact. It costs the health care system approximately $400 million every year. In connection with these reasons, CMS argued that “patients often have a urinary catheter longer than necessary,” making the majority of them develop urinary tract infection that was not meant to happen (Fox, Kaye & Urman, 2012).

As introduced above, UTI is one of the facilities that are highly used in hospitals. There are many other facilities in the health care system that when not used appropriately may result in patients acquiring preventable conditions from hospitals. As a result of the cost associated with the hospital facilities such as UTIs as well as hospital infections such as the urinary infections that result from having the urinary catheter for many days, CMS recommended the evaluation of patients in every shift so as to determine whether a particular facility is of necessity to the patient (Vincent, 2011).

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