On Monday, the Department of Health and Human Services ("HHS") issued a proposed rule which, among other things, modifies the Affordable Care Act's ("ACA") provision that hospitals with more than 50 beds must satisfy certain patient safety and quality improvement requirements, including participation in a patient safety organization ("PSO"), in order to contract with a qualified health plan ("QHP") through Cover Oregon or another health insurance exchange. As originally written, the ACA mandated that QHPs could contract with hospitals with more than 50 beds only if they meet certain patient safety requirements, including the use of a patient safety evaluation system ("PSES"). The proposed rule clarifies the PSES provision and defines it consistent with the Patient Safety & Quality Improvement Act, defining a PSES as "the collection, management or analysis of information for reporting to or by a patient safety organization (PSO)."
Under pressure from hospitals and systems already dealing with ACA compliance deadlines, the Centers for Medicare & Medicaid Services ("CMS") proposes to delay and phase in the PSO participation requirement through temporary alternatives. In phase one, CMS proposes that hospitals could, in lieu of full PSO participation, qualify for QHP contracts by meeting the Medicare Conditions of Participation (by being either Medicare-certified or being Medicaid-only). Phase one is intended to last two years or until further guidelines are issued. Most commentators feel the delay is simply to give hospitals additional time to contract with a certified PSO (or form their own), and does not signal an end to this patient safety and quality improvement requirement.
The full text of the proposed rule (pertinent language begins at p. 72369) is here: http://www.gpo.gov/fdsys/pkg/FR-2013-12-02/pdf/2013-28610.pdf