Medicaid will not reimburse hospitals for preventable serious complications—or “serious adverse events”—beginning Jan. 14, 2008.
For instance, hospitals will have to absorb the cost of surgery performed on the wrong body part or patient death or serious disability from a medication error.
The new policy encourages hospitals to use evidence-based approaches to avoid serious adverse events and improve patient care.
Full or partial payment can be denied when a serious adverse event:
- Occurred because of an error or other system failure
- Was within control of the hospital
- Occurred during an inpatient admission
- Resulted in significant harm
For more information on Medicaid’s new policy, including coding guidelines, read the Pennsylvania Department of Public Welfare’s Medical Assistance Bulletin.