The Centers for Medicare and Medicaid Services (CMS) announced on July 31 its final acute care inpatient prospective payment system (IPPS) rule, which updates Medicare payments to hospitals for FY09 and includes payment provisions to reduce never events that occur in hospitals.
CMS’s action brings to 11 the number of never events for which it will not make additional payments, with the inclusion of the following:
* Surgical site infections following certain elective procedures, including certain orthopedic surgeries, and bariatric surgery for obesity
* Certain manifestations of poor control of blood sugar levels
* Deep vein thrombosis or pulmonary embolism following total knee replacement and hip replacement procedures
In addition to the final rule, CMS sent a letter to state Medicaid directors providing information about how states can adopt the same never events practices. The letter specifically encourages states to adopt the same nonpayment policies outlined in the final rule. Nearly 20 states already have or are considering methods to eliminate payment for some never events.
The final rule will appear in the Aug. 19, 2008, issue of the Federal Register, and will be effective for discharges on or after Oct. 1, 2008. It updates payment policies and rates for more than 3,500 hospitals that receive Medicare payment. Overall, the final rule is estimated to increase Medicare payments to acute care hospitals by nearly $4.75 billion. Read the press release.
