Nonpayment for harms resulting from medical care: catheter-associated urinary tract infections.

FIRST, DO NO HARM” IS ONE OF THE ENDURING PRINciples of the health care professions. In a painful irony, however, the current reimbursement system not only fails to penalize hospitals for largely preventable harms due to medical care, but it often rewards them in the form of additional reimbursement. That paradigm will change, however, in response to a modification to the Inpatient Prospective Payment System (IPPS), which the Centers for Medicare & Medicaid Services (CMS) instituted on August 1, 2007. Following a congressional mandate, the CMS has reshaped the reimbursement system to hold hospitals accountable for failing to avert 8 largely preventable harms (BOX) resulting from medical care.