Medicare: Uncle Sam’s New Scrutiny
Medicare says it will stop paying hospitals to fix their ‘mistakes.’ Is your practice next?
By Barbara A. Gabriel
Superman was the victim of a medical mistake.
Sound far-fetched? The Man of Steel survived a spinal cord injury so severe that it left him paralyzed from the neck down for the last nine years of his life — years that he spent actively defying his doctors’ dire predictions by living an active life and advocating for medical research.
Ultimately — under the care of his devoted wife and the best doctors money could buy — Christopher Reeve died from a pressure ulcer, more commonly known as a bed sore. The infections that can result from bed sores are not uncommon. Obese patients and victims of paralysis are often confined to the same positions for extended periods of time, and pressure ulcers can develop even under the best medical care.
But under a new Medicare rule that will take effect October 1, 2008, Reeve’s death would be attributable to a medical error. And Medicare has announced that it will no longer reimburse hospitals for remedying a specific list of events — including pressure ulcers — that CMS deems preventable.
So what does this mean for you?
Pressure ulcers are on a list of 28 medical errors, or “never events,” defined by the National Quality Forum (NQF) in 1992 as preventable medical mistakes that the forum says should never occur in a hospital (see “Never Events” text box). In addition to pressure ulcers, these events include medication errors, falls, and much more egregious mistakes such as wrong-site surgeries. Continued...
