Corporate Compliance

New York State Medicaid will no longer reimburse for certain 'never events'

Compliance Monitor, June 11, 2008

Starting in October, New York’s state Medicaid program will stop reimbursing hospitals for 14 different types of avoidable medical errors that can cause serious complications for their patients.

According to a statement released by the state’s Department of Health, Medicaid will no longer reimburse hospitals for the following avoidable errors:

 

 

  • Surgery performed on the wrong body part
  • Surgery performed on the wrong patient
  • Wrong surgical procedure on a patient
  • Foreign object inadvertently left in patient after surgery
  • Medication error
  • Air embolism
  • Blood incompatibility
  • Patient disability from electric shock
  • Patient disability from use of contaminated drugs
  • Patient disability from wrong function of a device
  • Incidents whereby a line designated for oxygen intended for patient is wrong item or contaminated
  • Patient disability from burns
  • Patient disability from use of restraints or bedrails
  • Patient disability from failure to identify and treat hyperbilirubinemia (bilirubin in blood) in newborns

    The health department will continually review the list, which it will revise and expand over time.

    Hospitals that receive money from the Medicaid program will be required to document any complications that are present on a patient’s admission in order to better determine what conditions were a result of poor hospital care. The statement cited a 1999 report issued by the Institute of Medicine that estimated 98,000 annual deaths are the result of medical errors.

    The state health commissioner, Richard F. Daines, MD, said the new policy is designed to raise awareness about medical mistakes and reduce the likelihood that they will occur in the future.

    Medicare announced in August 2007 that it would stop paying for eight preventable complications and in April proposed adding nine more preventable complications to the list.

     

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