CMS Reimbursement Rules for Never Events: Impact on Healthcare

This report discusses the implementation and impact of the Centers for Medicare & Medicaid Services (CMS) reimbursement rules for 'never events,' which are preventable medical errors that should not occur in a healthcare setting. CMS has implemented policies to withhold payments for services related to these events, aiming to incentivize hospitals and healthcare providers to improve patient safety and reduce preventable complications. The report highlights specific examples of never events, such as air embolisms, retained foreign objects after surgery, and surgical site infections, and emphasizes the role of nursing care in preventing these occurrences. It also mentions that many states are adopting similar policies to align with CMS guidelines, and that the goal is to minimize patient harm and reduce unnecessary costs associated with these avoidable medical errors. Desklib provides access to similar solved assignments and study resources.

Running head: CMS REIMBURSEMENT RULES FOR NEVER EVENTS 1
CMS REIMBURSEMENT RULES FOR NEVER EVENTS
Name
Institution

CMS REIMBURSEMENT RULES FOR NEVER EVENTS 2
The rule for never events was necessary becaus the health practitioners are required to
know the kind of patients they treat. Also, the practitioners ensure they understand the need of
the patients because the doctors bare the liability of any error that might be deemed preventable
or any error that should not happen in the presence of a trained and qualified health practitioner.
According to Cherry & Jacob, (2016), the center of Medicare &Medicaid Services
deliberated about the never events that led to the abolishment of payment to activities that
include preventable complications and injuries. In the list of the ten categories of hospital-
acquired conditions, air embolism, blood compatibility, objects that are foreign and retained after
surgery, falls and trauma, surgical site infections to name a few, these rules impact the nursing
care.
Medicare plans have set the mandate for hospitals to achieve high-quality services and
anticipate to bring the Medicaid program on board. In this regard, the CMS announced their
inpatient payment procedures prospective. Thus, orchestrating the introduction of additional
conditions that will not be reimbursed at the same time providing the necessary incentives to
boost the quality of healthcare.
In the recent past, the CMS drafted a letter to State Medicaid Directors giving directions
on how the various States should emulate policies related to never event payment as enumerated
in the IPS rule. According to the report from CMS, about 20 States have agreed to forego the
payment procedures whenever the patient is suffering from a serious medical condition (Jacob
Arriola et al. 2016).
It is noticeable the never events might orchestrate serious injury that might even lead to
the death of the beneficiaries as well as bringing in unnecessary cost damages to Medicaid and
Medicare. Therefore, nowadays the steps taken are meant to prohibit such cases from happening.

CMS REIMBURSEMENT RULES FOR NEVER EVENTS 3
References
Cherry, Barbara, and Susan R. Jacob. Contemporary nursing: Issues, trends, & management.
Elsevier Health Sciences, 2016.
Jacob Arriola, K. R., Hermstad, A., St. Clair Flemming, S., Honeycutt, S., Carvalho, M. L.,
Cherry, S. T., ... & Kegler, M. C. (2016). Promoting policy and environmental change in
faith-based organizations: outcome evaluation of a mini-grants program. Health
promotion practice, 17(1), 146-155.