Beginning in October, the New York State Medicaid program will deny reimbursements on 14 “never-events”- avoidable hospital complications and medical errors. These “never events” include surgical errors such as procedures performed on the wrong body part or the wrong patient.
Hospitals receiving payment under New York Medicaid will be required to provide information on each admission that will designate which complications were present on admission, and which ones occurred during or as a result of hospital care. By working with the hospital and clinical community, this information will help the Medicaid program determine when increased payment for complications will be denied.
14 Avoidable Hospital Conditions NYS Medicaid has Identified as Non-Reimbursable:
- Surgery performed on the wrong body part
- Surgery performed on the wrong patient
- Wrong surgical procedure on a patient
- Foreign object inadvertently left in patient after surgery
- Medication error
- Air embolism
- Blood incompatibility
- Patient disability from electric shock
- Patient disability from use of contaminated drugs
- Patient disability from wrong function of a device
- Incidents whereby a line designated for oxygen intended for patient is wrong item or contaminated
- Patient disability from burns
- Patient disability from use of restraints or bedrails
- Patient disability from failure to identify and treat hyperbilirubinemia (bilirubin in blood) in newborns.