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On March 7, 2015, Posted by , In Home Care, By ,,,, , With Comments Off on Home Care Services in Warren, MI

Medicaid to Cease Payment for Some Medical Mistakes

To manage the skyrocketing cost of healthcare, Medicaid, like its partner program, Medicare, plans to cease reimbursing hospitals for ‘never events’ and the complications that arise from them.

A ‘never event,’ as defined by the U.S. Department of Health and Human Services (HHS), is a mostly preventable, alarming medical mistake. Examples include surgery performed on the wrong body part; a patient who commits suicide in a health-care facility; and patient kidnapping.

The Centers for Medicare and Medicaid Services, a sub-agency of HHS, has projected that this initiative will slash $35 million from Medicaid’s projected payouts over the next five years—but it will barely make a dent in the $364 billion Medicaid budget. The new rule becomes effective on July 1, 2012.

Medicaid’s move has rekindled the debate that was ignited when Medicare announced in 2008 that they would cease payment for ‘never events.’

The American Medical Association (AMA) is concerned that Medicaid’s decision may “have serious unintended consequences,” including lower-quality care for Medicaid recipients, and may actually increase costs rather than reduce them.

In a March 2011 letter to Donald Berwick, an administrator for CMS, AMA Executive Vice President Michael Maves outlined why he thought the rule will be bad for both health-care providers and patients.

Health-care providers will be exposed to increased liability, which could lead to a “Catch 22” situation where physicians, wary of lawsuits, withhold treatments that have “unpredictable” consequences. For example, doctors may decide not to prescribe some antibiotics that are given post-operatively to prevent certain kinds of infections but can sometimes allow others to flourish.

The result, he wrote, “will place Medicaid patients at further risk of reduced access to care and increased financial costs, with unproven benefits, on an already over-stretched Medicaid program.”

Source: agingcare.com

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