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Medicare’s “Never Events” Policy Belongs in Never-Never Land

Posted by Andrew J. Barovick | Nov 14, 2008 | 0 Comments

Did you know that as of the first week of October, 2008, Medicare no longer reimburses American hospitals when certain “reasonably preventable” events, known as “never events” (because they are never supposed to happen) actually do happen?  Kevin Sack reported this story in the October 1, 2008 NY Times , but it has yet to create the uproar that many in the medical/legal community expected it to.

The never events include:  post-operative infections; foreign objects left inside the patient after surgery; and a patient's receipt of a transfusion of incompatible blood.  It is never the patient's fault, but guess who ends up footing the bill when the hospital is stiffed by Medicare?  That's right.  You could be charged for the hospital's error, unless the hospital or individual physician volunteers to pay.  Advice to Medicare patients that are the victims of medical malpractice that Medicare re-brands as “never events”:  don't hold your breath waiting for the hospital or physician involved in committing the malpractice to pay up.

As Kevin Sack points out, this hits close to home, too, since New York is one of a number of states in which the Medicaid program has incorporated as many as 28 “never events” that they will not pay for.

If this sounds harsh, it is.  But, the ultimate goal here is apparently to get hospitals to be more careful in the future.  That is an admirable goal, but it should not be pursued at the patient's expense.

About the Author

Andrew J. Barovick

Mr. Barovick is a graduate of Columbia College and Cardozo School of Law. He began his legal career at the Queens District Attorney’s Office, where he tried over 20 felonies to verdict, and argued an equal number of appeals before the Appellate Division, Second Department, the New York Court of Appeals and the United States Court of Appeals for the Second Circuit.

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REPRESENTATIVE VERDICTS & SETTLEMENTS:

$7.9 million dollars for infant client who suffered severe brain injuries due to post- delivery medical malpractice.

$500,000 wrongful death/medical malpractice settlement on behalf of patient brought to hospital emergency room with serious injuries who suffered complications while unmonitored and died.

$425,000 wrongful death/medical malpractice settlement during trial on behalf of senior hospital patient whose surgeon failed to timely address her worsening symptoms, resulting in her death.

$250,000 to young man whose physician failed to diagnose an impending torsion testicle, causing the loss of the affected testicle.

$200,000 to young mother whose OB/GYN failed to timely diagnose and treat her ectopic pregnancy, resulting in excruciating, long-term pain and the need for surgery to address the ectopic pregnancy once it was diagnosed.

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