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For two years, a behind-the-scenes battle has waged between, among others, the Centers for Medicare & Medicaid Services (CMS) and The Joint Commission (TJC) over, of all things, hospital equipment maintenance.

Five members of the U.S. House of Representatives—four Republicans and a Democrat—sent a letter last month to the CMS telling it to hang tough in insisting that hospitals follow the manufacturer’s maintenance recommendations for what the CMS calls “equipment critical to patient health and safety.” That includes “equipment used for radiologic imaging.” The CMS laid out its latest rules in a December 2, 2011, memo.

One of those who signed the letter, Representative Tim Murphy, R-Pa, told the Washington newspaper The Hill that “weakening of equipment maintenance standards could have some severe consequences for health and safety.” He elaborated:

We’re not dealing with an automobile or refrigerator here. The consequences can be pretty deadly.

Poor maintenance of automobiles can have deadly consequences too, but never mind. Also signing the letter were Representatives Chris Gibson, R-NY, Mike Kelly, R-Pa, Keith Rothfus, R-Pa, and Allyson Schwartz, R-Pa.

DOTmed News sketched out the battle lines in a post today. Aligned with the CMS in supporting strict adherence to manufacturer guidelines are the American Society of Radiologic Technologists, the Intersocietal Accreditation Commission, and the American Association of Physicists in Medicine.

Biomedical engineers say they should be allowed to deviate from those recommendations if evidence (i.e., experience) warrants. Since 1994, TJC has approved such a “risk-based” approach. Aligned with TJC are ECRI Institute, the Association for the Advancement of Medical Instrumentation, and the American Society for Healthcare Engineering.

The dispute comes down to money, of course. Strictly following the manufacturer’s recommendations could cost more and require more personnel.

Last summer, George Mills, TJC’s director of engineering, told DOTmed News, “Over the past 17 years, there has not been an adverse event associated with the Joint Commission methodology for servicing both life support and non–life support equipment.”

CMS watchers expect some sort of final ruling soon.

Related CME seminar (up to 35.25 AME PRA Category 1 credits™): UW Radiology Review Course “Not Just for Residents”


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