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  • PART I ADMINISTRATION OF THE GOVERNMENT
    (Chapters 1 through 182)
  • TITLE XVI PUBLIC HEALTH
  • CHAPTER 111 PUBLIC HEALTH
  • Section 51H Reporting about healthcare-associated infections and serious reportable events, and serious adverse drug events; charges or reimbursement for resulting services prohibited

[ Subsections (a) and (b) effective until October 1, 2012. For text effective October 1, 2012, see below.]

  Section 51H. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:--

  "Facility'', a hospital, institution for the care of unwed mothers or clinic providing ambulatory surgery as defined by section 25B.

  "Healthcare-associated infection'', a localized or systemic condition that results from an adverse reaction to the presence of an infectious agent or its toxins that: (i) occurs in a patient in a facility, (ii) was not present or incubating at the time of the admission during which the reaction occurs, and (iii) if occurring in a hospital, meets the criteria for a specific infection site as defined by the federal Centers for Disease Control and Prevention and its national health care safety network.

  "Serious reportable event'', an event that results in a serious adverse patient outcome that is clearly identifiable and measurable, reasonably preventable, and that meets any other criteria established by the department in regulations.

  (b) A facility shall report data and information about healthcare-associated infections and serious reportable events. A serious reportable event shall be reported by a facility no later than 15 working days after its discovery. Reports shall be made in the manner and form established by the department in its regulations. The department may require facilities to register in and report to nationally recognized quality and safety organizations.

[ Subsections (a) and (b) as amended by 2008, 451, Sec. 65 effective October 1, 2012. See 2008, 451, Sec. 192. For text effective until October 1, 2012, see above.]

  (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:

  "Facility'', a hospital, institution for the care of unwed mothers or clinic providing ambulatory surgery as defined by section 25B.

  "Healthcare-associated infection'', a localized or systemic condition that results from an adverse reaction to the presence of an infectious agent or its toxins that: (i) occurs in a patient in a facility, (ii) was not present or incubating at the time of the admission during which the reaction occurs, and (iii) if occurring in a hospital, meets the criteria for a specific infection site as defined by the federal Centers for Disease Control and Prevention and its national health care safety network.

  "Serious adverse drug event'', any preventable event that causes inappropriate medication use in a hospital or ambulatory surgical center that leads to harm to a patient, as further defined in regulations of the department.

  "Serious reportable event'', an event that results in a serious adverse patient outcome that is clearly identifiable and measurable, reasonably preventable, and that meets any other criteria established by the department in regulations.

  (b) A facility shall report data and information about healthcare-associated infections, serious reportable events, and serious adverse drug events. A serious reportable event shall be reported by a facility no later than 15 working days after its discovery. Reports shall be made in the manner and form established by the department in its regulations. The department may require facilities to register in and report to nationally recognized quality and safety organizations.

[ Subsection (c) effective until October 1, 2012. For text effective October 1, 2012, see below.]

  (c) The department shall, through interagency service agreements, transmit data collected under this section to the Betsy Lehman center for patient safety and medical error reduction and to the health care quality and cost council for publication on its consumer health information website. Any facility failing to comply with this section may: (i) be fined up to $1,000 per day per violation; (ii) have its license revoked or suspended by the department; or (iii) be fined up to $1,000 per day per violation and have its license revoked or suspended by the department.

[ Subsection (c) as amended by 2008, 451, Sec. 65 effective October 1, 2012 until November 4, 2012. See 2008, 451, Sec. 192. For text effective until October 1, 2012, see above. For text effective November 4, 2012, see below.]

  (c) The department, through interagency service agreements, shall transmit data collected under this section to the Betsy Lehman center for patient safety and medical error reduction and to the health care quality and cost council for publication on its consumer health information website. Any facility failing to comply with this section may: (i) be fined up to $1,000 per day per violation; (ii) have its license revoked or suspended by the department; or (iii) be fined up to $1,000 per day per violation and have its license revoked or suspended by the department.

[ Subsection (c) as amended by 2012, 224, Sec. 79 effective November 4, 2012. For text effective until November 4, 2012, see above.]

  (c) The department, through interagency service agreements, shall transmit data collected under this section to the Betsy Lehman center for patient safety and medical error reduction for publication on the center for health information and analysis consumer health information website and for reporting quality data to providers. Any facility failing to comply with this section may: (i) be fined up to $1,000 per day per violation,-(ii) have its license revoked or suspended by the department; or (iii) be fined up to $1,000 per day per violation and have its license revoked or suspended by the department.

[ Subsection (d) effective until June 19, 2012. For text effective June 19, 2012, see below.]

  (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.

[ Subsection (d) as amended by 2012, 118, Sec. 17 effective June 19, 2012 until October 1, 2012. For text effective until June 19, 2012, see above. For text effective October 1, 2012, see below.]

  (d) The department shall promulgate regulations prohibiting a health care facility from charging or seeking reimbursement for services provided as a result of a healthcare-associated infection or the occurrence of a serious reportable event. Except as the executive office of health and human services otherwise provides for services to MassHealth members consistent with section 2702 of the Patient Protection and Affordable Care Act (P.L. 111-148), a health care facility shall not charge or seek reimbursement for a healthcare-associated infection or a serious reportable event that the facility has determined, through a documented review process and under regulations promulgated 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; provided, however, that for services to MassHealth members, the health care facility shall perform this documented review process and determination solely for the purposes of reporting to the department.

[ Subsection (d) as amended by 2012, 118, Sec. 18 effective October 1, 2012 . See 2012, 118, Sec. 69. For text effective until October 1, 2012, see above.]

  (d) The department shall promulgate regulations prohibiting a health care facility from charging or seeking reimbursement for services provided as a result of a healthcare-associated infection or the occurrence of a serious reportable event. Except as the executive office of health and human services otherwise provides for services to MassHealth members consistent with section 2702 of the Patient Protection and Affordable Care Act (P.L. 111-148), a health care facility shall not charge or seek reimbursement for a healthcare-associated infection or a serious reportable event that the facility has determined, through a documented review process and under regulations promulgated 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; provided, however, that for services to MassHealth members, the health care facility shall perform this documented review process and determination solely for the purposes of reporting to the department.

[ Subsection (d) as amended by 2008, 451, Sec. 65 does not take effect. See 2008, 451, Sec. 192 and 2012, 118, Secs. 18 and 69.]

  (d) The department shall promulgate regulations prohibiting a health care facility from charging or seeking reimbursement for services provided as a result of the occurrence of a serious reportable event. A health care facility shall not charge or seek reimbursement for a serious reportable event that the facility has determined, through a documented review process, and under regulations promulgated 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.