'Never event' Medicare reimbursement rules now in effect

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As of this month, Medicare no longer is reimbursing healthcare facilities for "reasonably preventable" medical errors. Also, hospitals are not allowed to charge patients directly for medical care resulting from such errors.

Preventable conditions that will no longer be reimbursed include falls, certain post-surgery infections, pressure ulcers, and infections resulting from improper catheter use. Three so-called "never events," or preventable errors, are also on the list. These are air embolisms, incompatible blood and objects left in the body after surgery. The move is expected to save only $21 million of Medicare's $110 billion annual outlay, but it represents the Bush administration's efforts to reform the country's medical payment system, according to The New York Times.

In related news, the Centers for Medicare & Medicaid Services Wednesday announced that it will publish most of the edits utilized in its Medically Unlikely Edit (MUE) program to improve the accuracy of claims payments. These edits will apply to claims made under Medicare Part B.
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