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Medicare and "never events"

According to the Centers for Medicare and Medicaid (CMS), a never event is a medical outcome that should never happen. These are serious mistakes, errors, and lapses that lead to significant negative outcomes, and patients in Colorado, Illinois and around the country may be entitled to compensation if a never event happens to them.

Never events

CMS came up with the idea of never events to target specific problems that they wanted to eliminate in their hospital partners. There are several different types of events, but they are all centered around conditions that will occur in a hospital setting, so they are also called "Hospital-Acquired Conditions". These conditions include examples such as falls by a patient that resulted in injury, transfusions with the wrong blood type, an infection at the site of surgery, leaving a foreign object in the body after a surgery, and others.

These events represent a serious breach of medical best practices whenever they take place. For each one, CMS will reduce payments to the hospital and the patient will not be considered responsible for the cost of any care associated with treating them. Moreover, they can potentially open up the hospital and the care team to a medical malpractice lawsuit due to the extent to which they represent a major and costly mistake. Private insurance companies follow similar guidelines as CMS when it comes to recognizing egregious medical mistakes.

It is the responsibility of the hospital and the doctors to avoid these mistakes and to maintain the proper level of care to ensure that their risk is minimized for the patients under their care in the hospital setting.

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