Noncoverage of Preventable Surgical Errors
On January 15, 2009, CMS announced three final national coverage determinations (NCDs) to deny Medicare coverage of certain types of serious, preventable surgical errors. Specifically, CMS will no longer cover: (1) wrong surgical or other invasive procedures performed on a patient; (2) surgical or other invasive procedures performed on the wrong body part; or (3) surgical or other invasive procedures performed on the wrong patient. The coverage policy complements CMS’s hospital-acquired conditions payment policy, under which Medicare will not make higher payments to hospitals for care associated with certain reasonably-preventable conditions unless the conditions were reported as present on admission. The NCDs are effective immediately, although implementation guidance will be issued at a later date.
