The Centers for Medicare & Medicaid Services (CMS) began denying payment for costs associated with treatment of select complications of hospital care, termed “never events” in October, 2008.
A study in the February issue of The Archives of Surgery found that CMS's list of current and proposed never events includes medical and surgical complications that may occur even when the highest current standards of care are met. Occurrence of these complications is related, in part, to external factors beyond a provider's control such as the complexity and severity of a patient's current medical conditions and the nature of required interventions.
The study concludes that if recognizable external factors influence the occurrence of never events, denial of payment for treatment of these complications will create an incentive to avoid treating high-risk patients.
(SOURCES: Patient Safety Monitor Alert, http://hcpro.com, February 17, 2010; Archives of Surgery, February, 2010)