Citing an analysis of patients undergoing the wrong surgery or surgery on the wrong patient or body part, the American Hospital Association has asked CMS to give some thought to the complexities of implementing its 'no pay for mistakes' policy. Before withholding payment, CMS should take several mitigating factors into account, AHA said. For example, it's asking CMS to create a policy to consider mixed events, such as when a provider nearly but doesn't complete a procedure on a wrong site, discovers the error, stops the procedure and begins on the correct site.
The AHA has adopted its own set of principles that describe when hospitals should not expect payment for care related to preventable, serious adverse events. Along those lines, it's asking CMS to consider three key questions as it begins to consider a national coverage determination for the three surgical conditions. These questions include how the adverse event will be defined, how accountability will be assigned and what costs or services should not be covered.
To learn more about the AHA's position:
- read this Healthcare Finance News article
Related Articles:
Medicare to expand 'no-pay' list
By 2008, Medicare won't pay for hospital errors
BCBS plan phasing out pay for errors, 'never events'
SPOTLIGHT: AMA says CMS 'no-pay' list is unrealistic