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HistoryBeginning in 2007, the Centers for Medicare and Medicaid Services (CMS) authorized hospitals designated as “trauma centers” to bill and receive payments for critical care services using specific codes and charges that capture the level of expertise and resources used in the triage and care of individual trauma patients. The CMS rules, can be accessed here. The CT Legislation and Purpose In 2019, HYPERLINK "" Public Act 19-117 Sec. 245 modified Connecticut General Statute Section 19a-644 to authorize the Office of Health Strategy to obtain data and information from short term acute care general and children’s hospitals on charges for trauma activation fees. What is the statutory authority for this new filing requirement and when is it due?Effective February 2020,?Public Act 19-117 Sec. 245?requires the filing of this information no later than?February 28, 2020?and annually thereafter.What is Trauma Activation Fee? It is a one-time occurrence in association with deployment of the hospital’s specialized trauma response team. The related reimbursement for this occurrence is commonly known as a “trauma activation fee.” A primary purpose of the CMS trauma team activation codes and related fees payment system is to help trauma centers remain financially viable, given the significant cost burden associated with professional and administrative resources needed to achieve and maintain the advanced level of readiness and capability of their critical care services.BillingRevenue code series 68x can be used only by trauma hospitals designated by the state or local government. Different subcategory revenue codes are reported by designated Level 1-4 hospital trauma hospitals. CMS created G0390, Trauma response team activation associated with hospital critical care service, effective January 1, 2007, which is assigned to APC 0618, and Critical Care with Trauma Response. To determine whether trauma activation occurs, providers are to follow the National Uniform Billing Committee (NUBC) guidelines listed in the Medicare Claims Processing Manual, Publication 100-04, Chapter 25, § 60.4.CMS Manual? What is a designated trauma center?States designate and license trauma centers and the American College of Surgeons (ASC) verify if the designated centers have the resources listed in the Resources for Optimal Care of the Injured Patient on-site. Each center achieves and maintains its designation through a self-funded rigorous verification process administered by ACS. How many designated trauma centers in Connecticut?Connecticut has 12 adult and/or pediatric trauma centers designated and licensed by the Department of Public Health The American College of Surgeons. The very rigorous trauma center re-verification process by the ACS takes place every three years.Trauma Centers in ConnecticutTrauma Level ITrauma Level IITrauma Level III1. Connecticut Children’s Medical Center (Pediatric)1. Bridgeport Hospital2. Danbury Hospital1. William W. Backus Hospital2. Hartford Hospital3. Norwalk Hospital3. Saint Francis Hospital and Medical Center5. St. Vincent’s Medical Center4. Yale-New Haven Hospital (Adult, Pediatric)6. Stamford Hospital7. Waterbury HospitalWhat is a trauma center level?ACS provides detailed criteria to assist trauma centers in establishing policies to set the right level of response in a trauma team activation based on three key domains: the patient’s physiologic status, the patient’s anatomic status, and the mechanism of injury. A trauma center’s policies also may use other factors to optimize trauma care, including patient’s age, bleeding disorders, burns, end-stage renal disease, advanced pregnancy, time-sensitive extremity injuries, CPR, blunt force or penetrating trauma, and other similar elements. Every trauma center has a policy that is consistent with the ACS guidelines to outline how the hospital will respond to critical care patients. Table 2 provides a summary of the capabilities and resource needs for each trauma center designation level. CMS rules, ACS and NUBC also provide additional information and current updates to trauma activation rules, charges and payments. Trauma Center Levels Resource Needs and CapabilitiesElements of Capabilities and ResourcesTrauma Center LevelsLevel ILevel IILevel IIIGeneral descriptionCenter serves as comprehensive regional resource and is a tertiary care facility central to trauma systemProvides total care for every aspect of injury- from prevention through rehabilitationFacility able to initiate definitive care for all injured patientsFacility has demonstrated an ability to provide prompt assessment, resuscitation, surgery, intensive care, and stabilization of injured patients and emergency operations24-hour in-house immediate coverageBy general surgeonsBy general surgeonsBy emergency medicine physiciansOnsite prompt availability Specialty care in orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, plastic surgery, oral and maxillofacial, pediatric, critical care, etc.Specialty care in orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, and critical careGeneral surgeons, and anesthesiologistsReferral sourceIs a referral source for communities in nearby regionsMay refer tertiary care needs such as cardiac surgery, hemodialysis, and microvascular surgery to a Level I Trauma CenterHave developed transfer agreements for patients requiring more comprehensive care at a Level I or Level II Trauma CenterQualityIncorporate a comprehensive quality assessment programIncorporate a comprehensive quality assessment programIncorporate a comprehensive quality assessment programPrevention and education - staffProvide continuing education of the trauma team membersProvide trauma prevention and continuing education programs for staffOffer continued education of the nursing and allied health personnel or the trauma teamPrevention and education - publicProvide leadership in prevention and public education to surrounding communities Operate an organized teaching and research effort to help direct new innovations in trauma careInvolved with prevention efforts and must have an active outreach program for its referring communitiesInvolved with prevention efforts and must have an active outreach program for its referring communitiesPrograms offered to patientsOffer programs for substance abuse screening and patient interventionN/AN/AVolume requirementsMeet minimum requirement for annual volume of severely injured patientsN/AN/A ?When and how should trauma fee information be reported?Hospital should file the required information as a part of their Annual Reporting Filing through Hospital Reporting System as follows:Report 24A - Hospitals Trauma Activation Fee policies and procedures in effect for the hospital’s most recently completed fiscal year,?duly dated. The policies and procedures should include how hospitals are documenting the practice of charging trauma activation fees when services are provided in the hospital’s emergency room. The documents should also include the composition of the trauma team by clinical staff and specialty, when it is activated, when a patient is billed and any other related charges that are included in the bill.Report 24B - Hospitals should submit a separate file that contains the number of discharges billed a trauma activation fee, and the range of and total fees charged when a hospital’s trauma team is activated for a patient emergency for the most current full hospital fiscal year.The?Hospital Data Filing Instructions?at this link of the OHS website contains an Excel file template to be completed and submitted to ensure reporting consistency among all hospitals. Instructions for uploading all required information are?at this link? ................
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