AHA comments on national coverage analysis for surgical errors

AHA News: The AHA urged the Centers for Medicare & Medicaid Services to consider several questions as it deliberates a national coverage determination concerning when to withhold payment for certain serious surgical errors. In a letter commenting on CMS’ national coverage analyses of errors involving the wrong surgery or surgery on the wrong patient or body part, AHA said the analysis should consider how the events are defined, how accountability will be assigned, and what costs or services should not be covered. “We urge CMS to reflect on these questions and thoroughly consider the complexities and subtleties that may arise over the issue of serious, adverse events,” AHA said. Because of the many nuances surrounding the issue, the association recommended that CMS include an appeals process for hospitals to petition any decisions that they believe were made inappropriately. AHA recently adopted a set of principles articulating when hospitals would not expect payment from patients or their insurers or employers for care related to preventable serious, adverse events.