CMS offers guidance for state Medicaid programs and ‘never events’ billing

The Centers for Medicare & Medicaid Services (CMS) has issued a letter offering guidance for coordinating response to hospital providers billing for healthcare-acquired conditions known as “never events.” CMS states the purpose of the letter is to provide guidance related to coordination of State Medicaid payment policies with policies recently adopted by the Medicare program. This is needed when hospital providers bill for selected hospital-acquired conditions (HACs), including some conditions on the National Quality Forum’s (NQF) list of Serious Reportable Events (commonly referred to as “Never Events”). This letter specifically: provides a brief overview of CMS’ Medicare payment policy for selected HACs, provides a brief overview of policy considerations for State Medicaid programs; and provides direction as to how States can implement policies that are aligned with Medicare to prevent payment liability as a secondary payer. (SOURCES: HCPro Accreditation Connection ,, August 11, 2008; CMS website review,, August 11, 2008)