"Stop Sepsis Act"; Requires hospitals to establish sepsis recognition and treatment protocols, train staff, and establish quality measures.*
What changed between versions
The bill is now formally named the 'Stop Sepsis Act' (new Section 1).
Patient categories expanded from adult and pediatric to include geriatric and obstetric patients in protocol components.
Removed the requirement for hospitals to submit sepsis protocols to the Department of Health for review within 120 days and implement them only upon department approval. Hospitals may still revise and update protocols and resubmit no more than once every two years.
New Section 1(f): Third-party payors, managed care organizations, health benefits plans, and Medicaid contractors shall not substitute their own clinical judgment for that of the treating provider regarding sepsis diagnosis and treatment. This prohibits denial, downcoding, retrospective review, or payment reduction based on alternative clinical definitions, proprietary algorithms, payer-developed medical necessity policies, or retrospective clinical validation reviews when the diagnosis is documented per ICD-10-CM guidelines.
New Section 3 amends existing law (P.L.2007, c.196, Section 3) to require general hospitals to report quarterly to the Department of Health on CMS-identified process quality indicators for hospital infection control and CDC-identified infection rate data for major site categories, submitted through the National Healthcare Safety Network or successor system.
Protocol basis changed from 'generally accepted standards of care' to 'based on best practices.'
New Section 1(g) defines 'hospital' as a general or special hospital licensed under P.L.1971, c.136 (C.26:2H-1 et seq.).
Staff training requirement narrowed from 'professional staff with direct patient care responsibilities, and appropriate professional staff with indirect patient care responsibilities including laboratory and pharmacy staff' to 'clinical staff involved in the recognition, treatment, or prevention of sepsis.'
The Department of Health shall offer continuing education credits and other educational opportunities related to sepsis (such as health care provider briefings), subject to availability of funds.
Removed the requirement for hospitals to annually report data to the department for developing risk-adjusted sepsis mortality rates, and removed the provision that hospitals shall be subject to audit at the department's discretion.
Added a public 'report card' requirement: the Commissioner of Health must compile and publish on the Department of Health website an annually updated report card showing, for each hospital, the number of surgical inpatient sepsis cases, average length of stay, risk-adjusted mortality rate; same metrics for non-surgical inpatient cases; number of present-on-admission cases; and number of patients discharged to hospice. The commissioner must consult with hospitals, clinical experts, and the Quality Improvement Advisory Committee.
