Corporate Compliance

Medicare may stop paying for more 'never events'

Compliance Monitor, April 23, 2008

Medicare is considering expand the list of preventable medical errors, known as “never events,” that it will not pay to treat, according to an Associated Press article.
The proposed rule would add nine conditions to the list of never events Medicare will no longer pay to treat, including:
  • Surgical site infections following certain elective procedures
  • Legionnaires’ disease
  • Extreme blood sugar derangement
  • Iatrogenic pneumothorax
  • Delirium
  • Ventilator-associated pneumonia
  • Deep vein thrombosis/Pulmonary embolism
  • Staphylococcus aureus associated disease
  • Clostridium difficile associated disease
Medicare announced in August 2007 that it would stop paying for eight preventable medical errors in October 2008. Since then hospitals in four states-Pennsylvania, Massachusetts, Minnesota, and Washington-have agreed to waive fees 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. Insurer WellPoint has also said it will stop paying for some never events.



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