CMS Reimbursement for Never Events

Never Event Complications
Student’s Name
Institutional Affiliation
Implications of Never Events
It is evident that CMS rules for reimbursing never events required a radical change in the model of delivering patient care in inpatient facilities. It is imperative for physicians to heighten the level of precaution that they apply when dealing with patients to reduce or prevent the occurrence of “never event” complications (O’Rourke & Hershey, 2009). The change in the patient care delivery model emanates from the position held by CMS that it is possible to prevent “never event” complications by adhering to evidence-based practice in clinical settings. In other words, CMS attributes the rising cases of such complications to the negligence of physicians in inpatient facilities. While many inpatient settings have successfully created good systems to prevent “never event” complications, they are unable to follow-up the guidelines effectively.
Concerning evidence-based guidelines recommended by CMS, physicians in inpatient facilities should understand and apply the guidelines in making decisions in inpatient settings (O’Rourke & Hershey, 2009). This begins with becoming familiar with the complications that are not reimbursed by CMS whenever they arise following a surgical procedure or other inpatient procedure that results in complications due to physician negligence. Next, physicians should review the available guidelines on a regular basis to identify practices that will help in either reducing or eliminating “never event” complications.

Finally, physicians in such facilities should re-examine and update their practices in line with the incoming new information from CMS and other entities. Following the three steps will play a crucial role in helping the defense lawyer to argue that the hospital and physician complied with evidenced-based practice and guidelines. Thus, the lawyer will argue that the occurrence of the “never event” was just an unfortunate incident in which the patient suffered the complication despite having received high-quality care from the inpatient care team.
References
O’Rourke, P.T., & Hershey, K.M. (2009). Never-Event Implications. The Hospitalist. Retrieved from: https://www.the-hospitalist.org/hospitalist/article/124081/never-event-implications#