WellPoint to stop payments for 'never events'
Healthcare Auditing Weekly, April 8, 2008
Mirroring a new policy by CMS and at least four states, health insurer WellPoint will no longer pay for care resulting from serious medical errors, known as never events, according to a company press release.
WellPoint will begin its new policy by denying claims for coverage of:
- Foreign objects left in patients after surgery
- Operations on wrong body parts
- Operating on the wrong patient
It may also stop payments for:
- Hospital-acquired injuries
- Pressure ulcers
- Air embolisms
- Blood incompatibility
- Catheter-associated urinary tract infections
- Vascular catheter-associated infections
- Hospital-acquired injuries
- Chest infections after CABG
WellPoint is the country's largest health benefits company with 35 million beneficiaries.
Medicare announced in August 2007 that it would stop paying for preventable complications. Since then hospitals in four states-Pennsylvania, Massachusetts, Minnesota, and Washington-have agreed not to charge for all never events. Hospitals in other states have agreed to not charge for some never events. Insurer Aetna announced several weeks ago it will no longer pay for 28 never events.
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