The CMS officially released three rules that halt Medicare payments when medical procedures are performed incorrectly, on the wrong patient or body part.
“The national coverage policies for certain types of surgical errors are important steps for Medicare in working to reduce or eliminate their occurrence and their associated payments,” acting CMS Administrator Kerry Weems said in a written statement. “These policies have the potential to reduce causes of serious illness or deaths to beneficiaries and reduce unnecessary costs to Medicare.”
Additionally, the CMS said that for discharges since last October, Medicare would no longer pay hospitals a higher rate for an inpatient hospital stay if the reason for the enhanced payment is one of a number of hospital-acquired conditions as outlined in recent hospital payment rules.
The past two federal payment guidelines identified a number of so-called “never events” of which the CMS said it would withhold payment. Some of those include injuries related to falls and traumatic events, foreign objects retained after surgeries and blood incompatibility.
In December 2008, both the American Hospital Association and the American Medical Association said that they were opposed to the use of the national coverage determinations as a means to halt payments for such medical errors. Both associations said that the CMS needed to clarify. At the time, the AMA said that the federal agency should instead “develop a clear payment policy outlining the circumstances (under) which surgery claims would not be payable by Medicare.”
