Medicare is wading into dangerous territory here. Instead of further scrutinizing the current conditions on the no-pay list, they’re aggressively expanding it.

Policy makers should be aware of the unintended consequences of certain pay for performance measures.

A poorly thought-out no-pay list will lead to similar circumstances, paradoxically increasing costs and patient harm:

For example, even with the best treatment, blood clots remain relatively common in patients after knee and hip replacements, according to the Society of Hospital Medicine, a national group of hospital-based docs. What’s more, the new rules could add incentives for hospitals to over-use blood thinners in an effort to drive rates down.