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Medicare’s never events policies in Idaho

On Behalf of | Jul 12, 2022 | Medical Malpractice

The phrase “man is to error” is often used in Idaho to evince how some mistakes can still occur regardless of how well-planned or performed a task is. But, some errors are so bad that they should never happen to any human under any circumstances. This is because they often cannot be undone and will likely affect that person for the rest of their life or even lead to death.

“Never events,” explained

A “never event” is an error in healthcare that is clearly identifiable, preventable and serious in its consequences for patients. The National Quality Forum (NQF) has a list of 29 such events; some of them include:
• Surgical items being left inside a patient’s body after surgery
• The wrong limb being amputated
• Performing surgery on the wrong patient
• Administering the wrong blood type to a patient

What is Medicare’s policy on never events?

Medicare has a National Coverage Determination (NCD) policy that covers never events. According to this policy, if a never event occurs, even if it is not due to the patient’s pre-existing condition or other circumstances beyond the healthcare provider’s control, Medicare will not cover the costs associated with that event. This means that the provider will have to absorb those costs. Also, suppose it is determined that the never event was caused by medical malpractice, such as poor communication or inadequate staff training. In that case, the provider may be subject to sanctions from Medicare.

Sanctions can include everything from a warning letter to being excluded from the Medicare program entirely. In addition, the Centers for Medicaid and Medicare Services (CMS) has implemented a “Payment Error Prevention Program” which reduces or denies payments to providers who have a certain number of never events within a specified period.

The policy on never events is just one way that CMS is working to improve patient safety and quality of care in our healthcare system. But, it’s important to remember that while this policy may help to reduce the incidence of never events, it will not prevent them from happening altogether. As long as humans are involved in the healthcare process, there will always be the potential for errors. However, by increasing awareness of never events and implementing policies to curb them, they can hopefully be a thing of the past.