CMS Issues 3 National Coverage Determinations

The Centers for Medicare & Medicaid Services (CMS) has released uniform policies to prevent Medicare and its beneficiaries from paying for three so-called “never events” — serious, preventable errors, according to a CMS news release.

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CMS announced three national coverage determinations to set polices to cover non-payment for wrong surgical or invasive procedures on a patient; surgeries or procedures on the wrong body part; and surgeries or procedures performed on the wrong patient.

CMS Acting Administrator Kerry Weems said the policies have “the potential to reduce causes of serious illness or deaths to beneficiaries and reduce unnecessary costs to Medicare,” in the news release.

Beginning last October, CMS refused to pay hospitals at higher rates for inpatient stays if the sole reason for the enhanced payments was one of the adverse events acquired during the hospital stay.

CMS will develop national coverage determinations for other conditions, but these three are implemented immediately.

Read the CMS news release about the three national coverage determinations.

View the three policy determinations here, here and here.

 

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