A bill to prevent health care facility-acquired infections.

Summary: MRSA Infection Prevention and Patient Protection Act - Directs the Secretary of Health and Human Services to promulgate regulations that: (1) define "MRSA" (methicillin-resistant staphylococcus aureus); (2) provide a list of best practices for antibiotic resistant staphylococcus; (3) define "high risk hospital departments" for purposes of applying such practices; and (4) provide screening, recordkeeping, and other requirements as they relate to MRSA reductions.

Requires acute care hospitals to screen patients entering intensive care units and other high risk hospital departments. Directs the Secretary to: (1) establish a process and a timetable for extending the screening requirements to patients admitted to all hospitals by January 1, 2012, subject to a waiver; and (2) report to Congress, by January 1, 2009, on whether payment adjustments should be made under Medicare to assist certain hospitals in defraying the cost of screening for, and the subsequent treatment of, MRSA or similar infections.

Requires all hospitals to: (1) comply with specified MRSA best practices, including contact precautions and patient isolation; and (2) report by January 1, 2009, the number of cases of hospital-acquired MRSA and other resistant infection rates that occur in the facility. Requires the Secretary to: (1) develop systems of identifying infected transferred patients and promptly informing any facility that has transferred an infected patient; and (2) promulgate regulations to develop a program to provide technical assistance and educational materials to non-hospital Medicare providers to assist in preventing MRSA infections.

Permits a hospital to apply to the Secretary for a one-year increase in the amount of the capital-related costs payment made to the hospital under the prospective payment system, subject to specified repayment and certification requirements.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``MRSA Infection Prevention and 
Patient Protection Act''.

SEC. 2. DEFINITIONS.

    In this Act:
            (1) Acute care hospital.--The term ``acute care hospital'' 
        means a hospital that maintains and operates an emergency room 
        (including a trauma or burn center), surgical unit, birthing 
        facility, and such other unit that is highly susceptible to 
        acquiring or transmitting infections, as determined by the 
        Secretary through regulations.
            (2) Hospital.--The term ``hospital'' has the meaning given 
        such term in section 1861(e) of the Social Security Act (42 
        U.S.C. 1395x(e)) and includes critical access hospitals (as 
        defined in section 1861(mm) of such Act) and other entities 
        determined to be hospitals by the Secretary.
            (3) MRSA.--The term ``MRSA'' means Methicillin-Resistant 
        Staphylococcus aureus.
            (4) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.

SEC. 3. HOSPITAL INFECTION PREVENTION PROGRAMS.

    (a) Regulations.--
            (1) In general.--Not later than 5 months after the date of 
        enactment of this Act, the Secretary, in consultation with the 
        Director of the Centers for Disease Control and Prevention and 
        such independent experts as the Secretary determines 
        appropriate, shall promulgate regulations that--
                    (A) define the term ``MRSA'';
                    (B) provide a list of best practices for MRSA and 
                such other antibiotic resistant staphylococcus as the 
                Secretary determines appropriation;
                    (C) define the term ``high risk hospital 
                departments'' for purposes of applying the best 
                practices provided for under subparagraph (B), which 
                may include surgical, burn, neonatal, and such other 
                department as the Secretary may designate;
                    (D) provide screening, record keeping, and other 
                requirements as they relate to reductions in MRSA.
            (2) Consistency.--The regulations promulgated under this 
        subsection shall be consistent with the requirements of this 
        Act.
            (3) Effective date.--The regulations promulgated under 
        paragraph (1) shall take effect on the date that is 1 month 
        after the date on which such regulations are published in the 
        Federal Register, but in no case later than 6 months after the 
        date of enactment of this Act.
    (b) Screening Requirements.--
            (1) In general.--Not later than 6 months after the date of 
        enactment of this Act, all acute care hospitals shall screen 
        all patients entering intensive care units and other high risk 
        hospital departments (as defined in the regulations promulgated 
        under subsection (a)(1)).
            (2) Extension of requirements.--
                    (A) In general.--The Secretary, in consultation 
                with the Director of the Centers for Disease Control 
                and Prevention, shall establish a process and a 
                timetable for extending the screening requirements of 
                paragraph (1) to all patients admitted to all 
                hospitals.
                    (B) Requirements fully applied.--The timetable 
                established under subparagraph (A), shall require that 
                all patients be covered by the screening requirements 
                under paragraph (1) by not later than January 1, 2012.
                    (C) Waivers.--The Secretary may waive the 
                requirements of this paragraph--
                            (i) if the Secretary determines that the 
                        rate of MRSA (or similar infections) is 
                        declining; or
                            (ii) if the Secretary determines that such 
                        requirements should not apply to certain 
                        hospitals or units of hospitals because the 
                        danger of acquiring or transmitting MRSA (or 
                        similar infections) is no greater than it is of 
                        acquiring MRSA in the community.
            (3) Medicare payment adjustments.--Not later than January 
        1, 2009, the Secretary shall submit to the appropriate 
        committees of Congress, a report on whether payment adjustments 
        should be made under title XVIII of the Social Security Act (42 
        U.S.C. 1395 et seq.) to assist certain hospitals in defraying 
        the cost of screening for, and the subsequent treatment of, 
        MRSA (or similar infections). In preparing such report, the 
        Secretary shall give special consideration to the needs of 
        rural, critical access, sole community, and Medicare dependent 
        hospitals, and disproportionate share hospitals and other 
        hospitals with a disproportionate share of immune compromised 
        patients.
    (c) Best Practices.--In addition to any other best practices 
contained in the regulations promulgated under subsection (a), all 
hospitals shall comply with the following:
            (1) A hospital shall require contact (barrier) precautions, 
        as determined by the Secretary, be taken when treating patients 
        who test positive for MRSA colonization (as defined by the 
        Centers for Disease Control and Prevention).
            (2) Where possible, a hospital will isolate, with the same 
        staffing ratio per bed as in the non-isolated beds of the 
        hospital, or cohort patients colonized or infected with MRSA, 
        control and monitor the movements of such patients within the 
        hospital, and take whatever steps are needed to stop the 
        transmission of MRSA bacteria to patients who did not come into 
        the hospital infected or colonized with such bacteria. The 
        Secretary may suspend the application of this paragraph in the 
        case of an emergency.
            (3) All patients tested for MRSA shall be informed of the 
        results and such results shall be noted in the patient's 
        medical records.
            (4) Patients being discharged from intensive care units 
        shall be tested again for MRSA, and those patients testing 
        positive will be informed of their status, and that status will 
        be noted in the patient's medical records in case of 
        readmittance to a hospital.
            (5) A hospital shall educate their staff concerning modes 
        of transmission of MRSA, use of protective equipment, 
        disinfection policies and procedures, and other preventive 
        measures.
    (d) Reporting.--
            (1) In general.--Not later than January 1, 2009, all 
        hospitals shall, using the National Healthcare Safety Network 
        of the Centers for Disease Control and Prevention, report the 
        number of cases of hospital-acquired MRSA and other resistant 
        infection rates that occur in the hospital facility. The 
        Secretary shall develop a process for the risk adjustment of 
        such reports by hospitals.
            (2) Publication.--The Secretary shall develop a system for 
        the publication of hospital-specific MRSA and other infection 
        rates.
    (e) Non-Hospital Medicare Providers.--
            (1) MRSA infection reporting.--The Secretary, using the 
        MRSA and other infection information identified under section 
        (b) and such other billing and coding information as necessary, 
        shall develop a system of identifying infected transferred 
        patients. The Secretary shall define by regulation the term 
        infected transferred patient, and such term shall include any 
        patient who, after discharge from, or treatment at, a non-
        hospital Medicare provider (including, but not limited to, a 
        skilled nursing facility, end stage renal disease program, or 
        ambulatory surgical center), is admitted directly (or within 5 
        days of such discharge or treatment) to the hospital with MRSA 
        (or other infection). The Secretary shall establish a system to 
        promptly inform any facility that has transferred an infected 
        patient. Unless such facility can provide a reasonable 
        explanation that the infection was not acquired in that 
        facility, the facility shall submit to the Secretary a MRSA 
        infection action plan to reduce such infections.
            (2) Assistance.--The Secretary shall promulgate regulations 
        to develop a program to provide technical assistance and 
        educational materials to non-hospital Medicare providers 
        described in paragraph (1) in order to assist in preventing 
        subsequent MRSA infections.
            (3) Publication of certain information.--If a non-hospital 
        Medicare provider identified in a report submitted under 
        paragraph (1) fails to take steps, as described in the action 
        plan submitted under such paragraph, to combat MRSA infections, 
        the Secretary shall publish the name of the provider and the 
        number of MRSA infections from such provider in the previous 
        year.
    (f) Assistance.--
            (1) In general.--To provide for the rapid implementation of 
        MRSA screening programs and initiatives through the 
        installation of certified MRSA screening equipment and the 
        provision of necessary support services, a hospital may submit 
        an application to the Secretary for a 1-year increase in the 
        amount of the capital-related costs payment made to the 
        hospital under the prospective payment system under section 
        1886(g) of the Social Security Act (42 U.S.C. 1395ww(g)). The 
        Secretary shall approve all requests that the Secretary 
        determines are reasonable and necessary.
            (2) Repayment.--A hospital that receives an increase under 
        paragraph (1) shall, not later than 4 years after the date of 
        receipt of such increase, reimburse the Secretary for the costs 
        of such increase. Such costs shall include the accrual of 
        interest at the rate payable for Federal Treasury notes. Such 
        reimbursement may be in the form of reduced capital-related 
        costs payments to the hospital under the system described in 
        paragraph (1) for the years following the year in which the 
        increase was received.
            (3) Certification system.--Not later than 6 months after 
        the date of enactment of this Act, the Secretary shall 
        promulgate regulations for the development of a system to 
        certify appropriate MRSA screening and support services for 
        purposes of this subsection.