Medicaid Gets Tough on Hospital-Caused Injuries

     WASHINGTON (CN) – Medicaid will no longer reimburse states for patient expenses arising from the treatment of so-called “never events” – as in such an event should never happen – like leaving objects in a patient’s body after surgery, according to rules issued by the Centers for Medicare and Medicaid Services.




     The rules, mandated by the Affordable Care Act, list 26 other preventable conditions patients sometimes acquire during hospital stays for which Medicaid will not pay. The list includes: treatment of bedsores caused by failure to move patients regularly, infections caused by improper cleaning of catheters and surgical incisions, as well as broken bones and dislocations resulting from falls and slips.
     Under the Medicaid program, the federal government reimburses each state for a percentage of the cost to treat eligible patients. Until passage of the Act, states had full authority to make reimbursement decisions regarding hospital-acquired conditions.
     Only 21 states already had non-payment policies in place for hospital-acquired conditions. Out of those, 17 maintain a different list of conditions than those issued by the centers.
     The new rules forbid states from reducing treatment of patients eligible for Medicaid to cover the cost of the non-payment policy.

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