Waving Bills For Medical Errors
In September of 2007, the state of Minnesota decided it was no longer going to charge patients or insurance companies for medical errors from it’s hospitals. Now 23 states have followed suit (including New York) in making sure patients do not have to pay for gross errors in hospitals. The errors, called “never events”, are culled from a list of 28 errors created by the National Quality forum which include things such as surgery on the wrong body part and surgery on the wrong patient.
The idea of cutting payments for avoidable errors has gained considerable momentum in the year since federal officials sparked the shift by announcing that, starting Oct. 1, Medicare will no longer reimburse hospitals for the extra costs of treating certain injuries, infections and complications that occur after admission.
Medicare officials this month expanded the hotly contested list of eight errors for which it won’t pay to augment one condition and add two more: surgical site infections after elective orthopedic and bariatric operations; severe complications from poorly controlled blood sugar; and deep vein thrombosis or pulmonary embolism following total knee and hip replacement surgeries.
In addition, the agency urged state Medicaid directors nationwide to implement the non-payment policies, already in effect in Massachusetts, New York and Pennsylvania. It’s not clear how many others plan to follow.
Insurance companies are also getting in on the act, with the three biggest in the country (Cigna, Aetna, and Blue Cross/Blue Shield) saying they will also no longer pay for serious medical errors. But is it as simple as reading items off of a checklist and seeing if a medical error fits into a certain category?
“Just because something defacto occurred on that list, that doesn’t mean that it’s defacto the fault of the provider,” said Karen Nelson, senior vice president for clinical affairs at the Massachusetts Hospital Association.
Some of the conditions on the lists kept by NQF and Medicare may not be preventable or under the hospital’s control, added Dr. Dan Stultz, president of the Texas Hospital Association, which announced a new policy last month that recommends not billing for nine preventable errors.
“ABO blood compatibility? I don’t have a problem with that,” Stultz said. But if a titanium medical device fails because of a manufacturing defect, the hospital shouldn’t be held responsible, he added.
Many questions still arise when it comes to the situation, and a vast number of kinks will have to be worked out of the system, but it is a great step in the right direction to addressing the issue of medical errors and malpractice.
August 21st, 2008 at 8:44 pm
[...] up last week’s post on “never events” in regards to medical malpractice, here is the list of “28 errors that should never [...]