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Committee approves bill directing hospitals to develop sepsis protocols and align reimbursement definitions
Summary
House Bill 16‑86 would direct hospitals to develop sepsis protocols and seeks to align clinical definitions used for treatment with reimbursement practices; hospital association representatives said the issue is primarily a reimbursement mismatch stemming from a definitional change (Sepsis‑3).
Representative Stark presented House Bill 16‑86, a request from the hospital association directing hospitals to develop sepsis protocols for treating critically ill patients and asking payers to recognize a broader set of clinical sepsis definitions for reimbursement.
Scott Tilleen, vice president of advocacy for the hospital association, told the committee that a 2016 definitional change to the clinical definition of sepsis (Sepsis‑3) resulted in some patients who are being treated for sepsis not meeting the Sepsis‑3 billing definition, which can prevent hospitals from billing specifically for sepsis even while treating the patient. He said hospitals are treating sepsis today, but the reimbursement rules do not always align with the treatment and the bill seeks to align best practice with billing so hospitals can be reimbursed for sepsis care.
Committee members asked about the need for the bill and about fiscal impact; Tilleen and the presenter said hospitals treat sepsis now but that the bill addresses a reimbursement/definition problem and that a fiscal impact number was not available at the hearing.
The committee approved the bill on a recorded vote, reported as six yeas, zero nays.
