Medicare implements rules barring payment for preventable treatment

[JURIST] The US Centers for Medicare and Medicaid Services (CMS) [official website] on Wednesday implemented regulations [text, PDF] denying hospitals payment for treating conditions caused by some common medical errors [HHS backgrounder]. Those regulations, announced [CMS press release] last year, contain a so-called "never list" of preventable conditions for which hospitals may bill neither Medicare nor patients, including certain hospital-acquired infections, bedsores and complications from incorrect blood transfusions. The Committee to Reduce Infection Deaths [advocacy group] was among the organizations welcoming the new regulations [press release] on Wednesday, but it noted that many state health care programs lack similar rules. The New York Times has more.

The new regulations were authorized by the Deficit Reduction Act of 2005 [text], which directed the US Department of Health and Human Services (HHS), which oversees Medicare, to identify reasonably preventable conditions that result in high-cost or high-volume treatment and additional government payments. CMS noted in the regulations that it selected only "conditions where, if hospital personnel are engaging in good medical practice, the additional costs of the hospital-acquired condition will, in most cases, be avoided." An influential report [text; press release] issued by the Institute of Medicine [organization website] in 1999 found that preventable medical errors result in as many as 98,000 deaths each year and cost the United States as much as $29 billion.

 

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