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Kentucky legislature eyes bill seeking to ensure Medicaid coverage for early sepsis diagnosis

Left to right- Russ Renallo-Owensboro Health-Representative Amy Neighbors-Bill Sponsor and Deb Campbell-Kentucky Hospital Association
Stu Johnson
Left to right- Russ Renallo-Owensboro Health-Representative Amy Neighbors-Bill Sponsor and Deb Campbell-Kentucky Hospital Association

Kentucky lawmakers are taking up legislation focused on addressing early detection of sepsis. The measure relates to current Medicaid coverage in these cases.

Sepsis is a life-threatening organ dysfunction, secondary to infection. The legislation sets in statute, Medicaid coverage for the early diagnosis of sepsis. Committee testimony included reference to discussions nationally to limit coverage to more advanced sepsis as a cost saver. Russ Renallo is chief financial officer for Owensboro Health.

“It’s almost similar to not paying for a mammogram unless you know breast cancer is there. So, and not paying for sepsis unless there’s severe sepsis on the claim and organ disfunction,” said Renallo

 Deb Campbell is with the Kentucky Hospital Association. Campbell said there’s a 4% mortality rate, if sepsis is caught early.

“If we do not and the patient goes on to develop severe sepsis or septic shock, the mortality rate goes to 28 to 68 percent. So, that’s one in four people will die up to three in four people will die,” said Campbell.

Advanced sepsis can lead to amputations, severe cognitive deficits and death. The bill emerged from a House committee Thursday. Campbell said an early diagnosis process in emergency rooms has worked to reduce in-hospital deaths. The longtime nurse said preventing infection in any way and any place is the way to lower sepsis cases.

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Stu has been reporting for WEKU for more than 35 years. His primary beat is Lexington/Fayette government.
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