ASSEMBLY, No. 3633

STATE OF NEW JERSEY

213th LEGISLATURE

 

INTRODUCED JANUARY 13, 2009

 


 

Sponsored by:

Assemblyman HERB CONAWAY, JR.

District 7 (Burlington and Camden)

Assemblyman JOSEPH VAS

District 19 (Middlesex)

 

Co-Sponsored by:

Assemblywoman Wagner, Assemblymen Van Pelt, Rumpf, Ramos, Polistina, Munoz, Wolfe, Holzapfel and Conners

 

 

 

 

SYNOPSIS

     Requires DHSS to report certain patient safety indicators on a hospital by hospital basis and prohibits hospitals and physicians from charging patient for certain medical errors.

 

CURRENT VERSION OF TEXT

     As introduced.

  


An Act concerning patient safety and supplementing Title 26 of the Revised Statutes.

 

     Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

     1.  a. The Department of Health and Senior Services shall include in the New Jersey Hospital Performance Report issued annually by the department hospital-specific data from hospital procedure and diagnosis codes concerning the following patient safety indicators:

     (1)  Foreign body left during procedure;

     (2)  Iatrogenic pneumothorax;

     (3)  Postoperative hip fracture;

     (4)  Postoperative hemorrhage or hematoma;

     (5)  Postoperative deep vein thrombosis (DVT) or pulmonary embolism (PE);

     (6)  Postoperative sepsis;

     (7)  Postoperative wound dehiscence;

     (8)  Accidental puncture or laceration;

     (9)  Transfusion reaction;

     (10)  Birth trauma;

     (11)  Obstetric trauma- vaginal delivery with instrument;

     (12)  Obstetric trauma- vaginal delivery without instrument;

     (13)  Air embolism; and

     (14)  Surgery on the wrong side, wrong body part, or wrong person, or wrong surgery performed on a patient.

     b.  The Commissioner of Health and Senior Services, in consultation with the Quality Improvement Advisory Committee in the Department of Health and Senior Services, may include additional patient safety indicators in the annual report, by regulation.  The commissioner shall consider indicators that: (1) are recommended by the federal Agency for Healthcare Research and Quality or the Centers for Medicare and Medicaid Services; (2) are suitable for comparative reporting and public accountability, and are risk adjusted; (3) have a strong evidence base with no substantial evidence against their use for comparative reporting; and (4) can be measured through data that are available through hospital procedure and diagnosis codes.

 

     2.  a. A general hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) shall not charge or otherwise seek to obtain payment from a patient for costs associated with a hospital acquired condition subject to the hospital acquired condition payment provisions of the Medicare program, as established by regulation of the Centers for Medicare and Medicaid Services.

     b.  A physician licensed by the State Board of Medical Examiners pursuant to Title 45 of the Revised Statutes, who was the attending physician responsible for causing a condition for which a hospital is prohibited from charging or seeking payment from a patient pursuant to subsection a. of this section, shall not charge or otherwise seek to obtain payment from a patient for costs associated with the condition.

     c.  A general hospital shall be required to notify its patients of the provisions of this section on a form and in a manner prescribed by the Commissioner of Health and Senior Services.

 

     3.  The Commissioner of Health and Senior Services shall request the Quality Improvement Advisory Committee to study and make recommendations to the commissioner on how to expand public reporting by the department of patient pressure ulcers, patient infections due to hospital care, and falls by patients in general hospitals.

 

     4.  The Commissioner of Health and Senior Services shall, in accordance with the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), adopt such rules and regulations as the commissioner deems necessary to carry out the provisions of this act.

 

     5.  This act shall take effect on the 180th day after enactment, but the Commissioner of Health and Senior Services may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of this act.

 

 

STATEMENT

 

     This bill directs the Department of Health and Senior Services (DHSS) to include in the New Jersey Hospital Performance Report issued annually by DHSS hospital-specific data concerning the following 14 patient safety indicators:

     -- Foreign body left during procedure;

     -- Iatrogenic pneumothorax;

     -- Postoperative hip fracture;

     -- Postoperative hemorrhage or hematoma;

     -- Postoperative deep vein thrombosis (DVT) or pulmonary embolism (PE);

     -- Postoperative sepsis;

     -- Postoperative wound dehiscence;

     -- Accidental puncture or laceration;

     -- Transfusion reaction;

     -- Birth trauma;

     -- Obstetric trauma- vaginal delivery with instrument;

     -- Obstetric trauma- vaginal delivery without instrument;

     -- Air embolism; and

     -- Surgery on the wrong side, wrong body part, or wrong person, or wrong surgery performed on a patient.

     DHSS will use data from procedure and diagnosis codes recorded in hospital bills to compile the required information on patient safety indicators.  Most of the patient safety indicators listed in the bill are currently risk adjusted, by age, sex, diagnosis, and comorbidities, and are externally validated as suitable for hospital quality comparisons.  With the exception of air embolism and wrong surgery, the patient safety indicators listed in the bill were developed by the Agency for Healthcare Research and Quality.  The air embolism and wrong surgery indicators are added because they are already included by the Centers for Medicare and Medicaid Services in the list of hospital-acquired conditions or “never” events that are not eligible for payment under the Medicare or Medicaid programs.

     The bill also authorizes the Commissioner of Health and Senior Services, in consultation with the Quality Improvement Advisory Committee in DHSS, to include additional patient safety indicators in the annual report, by regulation.  The commissioner shall consider indicators that: (1) are recommended by the federal Agency for Healthcare Research and Quality or the Centers for Medicare and Medicaid Services; (2) are suitable for comparative reporting and public accountability, and are risk adjusted; (3) have a strong evidence base with no substantial evidence against their use for comparative reporting; and (4) can be measured through data that are available through hospital procedure and diagnosis codes.

     Since the conditions identified in the patient safety indicators are generally preventable medical errors, the bill seeks to insure hospital and physician accountability by providing that a general hospital shall not charge or otherwise seek to obtain payment from a patient for costs associated with a condition that is subject to the hospital acquired condition payment provisions of the Medicare program, as established by regulation of the Centers for Medicare and Medicaid Services.  Similarly, a physician who was the attending physician responsible for causing a condition for which a hospital is prohibited from seeking payment, shall not charge or otherwise seek to obtain payment from a patient for costs associated with the condition.

     The bill provides that a general hospital shall be required to notify its patients of the provisions of the bill on a form and in a manner prescribed by the commissioner.

     Finally the bill directs the commissioner to request the Quality Improvement Advisory Committee in DHSS to study and make recommendations to the commissioner on how to expand public reporting by DHSS of patient pressure ulcers, patient infections due to hospital care, and falls by patients in general hospitals.

     The bill takes effect on the 180th day after enactment, but the commissioner is authorized to take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of the bill.