CIGNA Joins In, Halts Reimbursement for Never Events
CIGNA Healthcare announced a new initiative to promote patient safety, announcing that they will no longer reimburse hospitals for avoidable hospital conditions and never events. The new reimbursement plan was described in a press release issued by the company.
This new policy follows that already laid out by the Centers for Medicare and Medicaid Services (CMS). The CIGNA policy will also go into effect on October 1st of this year. CMS recently expanded the list of conditions that fall under this policy of non-payment, described on HospitalBuyer. A previous article also described the expanding number of health insurers that have adopted similar policies.
One of the reasons cited by CIGNA that they will not reimburse for never events is because they are not medically necessary. The conditions cited by CIGNA that fall into the category as being unavoidable are the same as those already identified by CMS.
This new policy is limited, in part, by the existing contracts that CIGNA has with healthcare providers. The intent of this program is to limit the liability by patients who are insured under CIGNA for payment denials from hospitals.
In addition to ceasing reimbursement, CIGNA encourages healthcare facilities to implement policies to limit the occurrence of never events, particularly that created by the Leapfrog Group. That policy calls for providers and facilities to report never events and errors, complete a root cause assessment, waive costs related to the event, along with apologizing to patients and their family members.
April 22, 2008 Related topics: Finance, Trends, Quality, Safety, Errors