In October 2008 Medicare introduced a new reimbursement system, based upon 2002 industry standards, otherwise known as “never events.” This related to a determination by a number of non-profit organizations, at least one physician, multiple insurance companies and health care watch analysts who all concluded that many health care related problems should never occur in the hospital setting.
Seemingly agreeing with this standard of care, Medicare made clear to the hospital community that if any one of the enumerated "never events" occurred in a hospital, the hospital would not be permitted to be paid extra by Medicare for resolving the problem that they caused. Sadly it appears as though hospitals across the country are learning ways to code around this – in order that they can still charge taxpayers for fixing the problems that they caused ‑ problems which never should have happened. A number of articles are beginning to appear indicating that the industry itself is quite concerned about the incentives that hospitals face to inaccurately characterize their bills, in order that they do not need to comply with the nearly 5‑year-old Medicare Never Event reimbursement policy.
If any individual becomes aware of an institutionalized policy by an acute care center to defraud the United States government, there exists a number of whistle-blower laws designed to protect this person from retaliation and assist the government in retrieving monies lost to the fraud.