Centers for Medicare and Medicaid Services Drop Autopsy Requirement: Are Patients at Risk?

It may seem counterintuitive, but autopsies are an important part of patient safety. As described by Dr. Justin Rueckert, “The autopsy plays a vital role in quality assurance by providing education and feedback to clinicians” regarding the accuracy of their diagnoses, the efficacy of the treatment used, and the complications they encounter. Despite this vital role, the Centers for Medicare and Medicaid Services (CMS) recently removed a regulation that required hospitals to “attempt to secure autopsies in all cases of unusual deaths and of medical-legal and educational interest” in order to qualify for Medicare reimbursement.

CMS dropped the autopsy requirement as part of its effort to eliminate of modify regulations that it deems obsolete and burdensome. In its Final Rule (84 FR 51732, 51745), CMS stated that the autopsy requirement is “duplicative and burdensome” because each state already has its own autopsy requirements. Further, CMS stated that “removing this requirement would not prohibit hospitals from performing autopsies” and that it encourages “hospitals to establish policies regarding autopsies, where appropriate.”

The American Society for Clinical Pathology and other national pathology organizations strongly oppose CMS’s decision to drop the autopsy requirement. In a letter to the CMS Administrator, the American Society for Clinical Pathology argued state autopsy laws “are insufficient to protect public health” and therefore a requirement by CMS to perform autopsies is not redundant: “few states have laws requiring autopsies or providing discretionary authority for their performance.”

What are the benefits of autopsies?

Medical literature is largely unanimous regarding the benefits of an autopsy. Autopsies can determine the manner and cause of death. In doing so, autopsies can uncover medical mistakes and provide information from which the medical community can learn. Further, autopsies can discover new diseases and help the medical community understand disease processes. For example, autopsies have significantly improved the medical community’s understanding of Alzheimer’s disease and its progression. Autopsies can also help identify and evaluate new treatments. Indeed, the American Society for Clinical Pathology has stated, “Autopsies remain the gold standard for identifying cause of death and are an indispensable quality assurance tool for evaluating and improving medical care. […] Without autopsy data, the ability to conduct research into medical errors and the quality of patient diagnosis could be significantly undermined.”

With the removal of CMS’s autopsy requirement, a hospital’s policy and/or state law will govern whether an autopsy will be performed. If the hospital and the coroner refuse to do an autopsy, one may seek a private autopsy.

The effect of CMS’s decision to remove the autopsy requirement remains to be seen; however, this decision renewed attention to the overall decline in autopsy rates. According to the National Center for Health Statistics, autopsy rates have declined more than 50 percent from 1972 through 2007. Due to the benefits that autopsies provide, the declining autopsy rate has many healthcare practitioners concerned that patient health is at risk.

If you suspect that your loved one died as a result of medical error, contact one of Burg Simpson’s experienced medical malpractice attorneys in Cincinnati today. Our award-winning, compassionate attorneys would be happy to discuss your potential claim. Call 1-800-713-9340 or fill out our contact form for a FREE no-obligation consultation today.