tci Medicare Compliance & Reimbursement - 2008 Issue 29
HOSPITALS: Look For Longer List Of 'Never Events' From CMS
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Article Overview
This article covers CMS efforts to reduce preventable medical errors in hospitals through Medicare payment policy changes, hospital quality reporting requirements, and planned national coverage actions related to serious reportable events. It is relevant to hospital coders, compliance teams, revenue cycle staff, and quality professionals who track inpatient payment policy, hospital-acquired conditions, and CMS reporting programs.
Why This Topic Matters
The article describes Medicare payment and reporting changes that affect hospital reimbursement, compliance workflows, and quality measurement. It also highlights broader CMS and National Quality Forum efforts around preventable events that hospitals may need to monitor.
Article Sections
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CMS hospital payment policy changes
Overview of the CMS final inpatient payment rule and the general hospital policy changes discussed in the article. Covers the broader context of Medicare updates affecting acute care hospitals.
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Preventable conditions added to the no-pay list
Discussion of additional hospital-acquired conditions that CMS says will be subject to Medicare nonpayment. Focuses on the policy direction and the types of conditions involved.
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Planned coverage determinations for serious surgical errors
Summary of CMS plans to address certain serious reportable surgical events through National Coverage Determinations. Includes the broader patient-safety context referenced in the article.
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Hospital quality reporting and payment adjustments
Explanation of the expanded quality reporting program and related payment consequences for hospitals that do not report successfully. Also notes public reporting through CMS quality tools.
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Impact on inpatient payment rates
Discussion of the article’s overview of hospital payment updates under the Medicare inpatient prospective payment system. Includes the broader financial impact described by CMS and the article.
What You Will Learn
- How CMS is changing hospital payment policy to address preventable inpatient events
- What types of hospital quality reporting requirements are being expanded
- How CMS and other organizations frame serious reportable events in the hospital setting
- Why inpatient prospective payment updates matter for hospital reimbursement and compliance
Who Should Read This
- Hospital coders
- Hospital compliance staff
- Revenue cycle professionals
- Quality improvement teams
- Medicare billing staff
- Healthcare administrators
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