CMS issues coverage policies to protect patients from surgical errors
The Centers for Medicare & Medicaid Services has announced three national coverage determinations to establish uniform national policies to prevent Medicare from paying for certain serious, preventable errors in medical care.
The Centers for Medicare & Medicaid Services has announced three national coverage determinations to establish uniform national policies to prevent Medicare from paying for certain serious, preventable errors in medical care.
The following errors, called “never events,” covered in these national coverage determinations are identified in the National Quality Forum’s list of serious reportable events:
• wrong surgical or other invasive procedures performed on a patient
• surgical or other invasive procedures performed on the wrong body part
• surgical or other invasive procedures performed on the wrong patient.
Consistent with current policy, Medicare also does not cover any services related to these non-covered services.
“The national coverage policies for certain types of surgical errors are important steps for Medicare in working to reduce or eliminate their occurrence and their associated payments,” said CMS Acting Administrator Kerry Weems. “These policies have the potential to reduce causes of serious illness or deaths to beneficiaries and reduce unnecessary costs to Medicare.”
Potential code for prior authorizations on AMA CPT Editorial Panel meeting agenda
March 28th 2024"Good public and economic policy must align costs, benefits, and incentives; currently, all costs are incurred by physician practices, and all financial savings and benefits from prior authorization accrue to health insurance plans, leading to perverse incentives,” says Alex Shteynshlyuger, MD.
