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Press Start: Lead an Empowered Life as a Clinical Laboratorian

Never Events

Published July 14, 2008 10:19 AM by Glen McDaniel

New York Medicaid program has announced it will not pay for what it terms 14 "never events."

I recently wrote a blog discussing the fact that Medicare, a major healthcare payer, will no longer pay hospitals for the cost of care deriving from medical mistakes or nosocomial infections.

State Medicaid programs have been hit with lowered federal payments and have been looking for ways to reduce cost while improving quality of care.

New York has identified 14 events that in its estimation are the results of hospital errors, incompetence or failure to follow established procedures. As in the case of the Medicare (CMS) list, these "never events" often add to the cost of care and use valuable hospital resources. However, providers should not be rewarded for delivering less than optimum care. The nation's largest Medicaid program might very well nudge other states to follow suit.

Two of these "never events" relate to laboratory tests: blood incompatibility and patient disability from failure to treat hyperbilirubinemia in neonates. As stated in the earlier blog, it is not a stretch to imagine that this list will be expanded to include other lab tests and might even lay more responsibility for turnaround time, incorrect results used to guide treatment inappropriately, and how lab tests are utilized at the feet of laboratorians in the near future.


A few days ago, CMS expanded its list of "Never Events" for which it will not pay.

The 3 new conditions are:

1. surgical site infections post certain elective orthopedic and bariatric surgeries

2. manifestations of poor management of blood glucose levels

3. DVT or pulmonary embolism after total knee or hip replacement

As I predicted early on, this list will continue to grow and the restrictions will increasingly be passed down from the federal to the state level (affecting Medicare as well as Medicaid payments).

One prediction which has not yet come true, but I still stand by is that because of the role the laboratory plays in providing clinical data, the lab will be ever more important in providing inclusive/exclusive data for never events and may eventually be held more accountable for providing complete, timely information

Glen McDaniel August 5, 2008 2:25 PM
Atlanta GA

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