Fierce Healthcare reports that Aetna and WellPoint have begun to include provisions in some contracts that they will not pay for (or let patients be billed for) care related to 28 “never events” compiled by the National Quality Forum. Aetna is including provisions in contracts with hospitals which bar payment for all 28 never event. WellPoint, meanwhile, is starting on a more limited basis, refusing payment for four of the 28 items in the list for insureds in Virginia.
Other large insurers, including UnitedHealth Group and Cigna are considering moves, as are all 39 members of the Blue Cross Blue Shield Association. Meanwhile, hospitals in Minnesota and Massachusetts have voluntarily agreed to not charge for all or at least some of the 28 never events identified by the NQF.
The Centers for Medicare & Medicaid Services will no longer pay for never events starting Oct. 1, 2008. Other major insurers have said they will adopt similar policies.