Introduction to Michael Streiff’s Article This is an in-depth analysis of the implications of the October 2008 “Never Event” decision by the Center for Medicare and Medicaid (CMS) to withhold reimbursement for any patient who develops a deep vein thrombosis (DVT) after hip or knee replacement. Since NBCA is a patient led organization, it immediately expressed reservations about the zeal in such a “black and white” policy, since it overlooks the “grays” in the fact that clots may ensue when there is appropriate thromboprophylaxis given, or even withheld appropriately due to contraindication in certain patient populations.
The article is a welcome addition to NBCA’s website, because it not only challenges the limitations of a “Never Event” that may be constructive in intent, it delineates specifically its unintended consequences. The authors were presenters at the NBCA Stop The Clot® Forum at Johns Hopkins Medical Center on October 18, 2008, so the thrombosis and thrombophilia patients in the Baltimore benefitted from their medical expertise and approachability.
Please note NBCA’s impact on CMS decisions and the planned follow-up already included on the website.