Personal Injury Law

Medicare, Others Won't Pay for Medical Errors

By Nick DiCello

The Centers for Medicare and Medicaid Services (CMS) will no longer pay for care resulting from certain medical errors widely seen as preventable, including certain "never events." For example, Medicare will not pay a hospital or physician for a surgical procedure performed on the wrong patient or on the wrong body part. Nor will Medicare pay for procedures requred to remove foreign bodies, like sponges, left inside patients during surgeries. Additional events, including certain infections, injuries from falls, and serious bed sores have also made the list of conditions for which Medicare will no longer pay. Furthermore, hospitals are not permitted to charge the patients who have been harmed by these errors.

Finally... instead of rewarding hospitals for the quantity of procedures performed, our health care system, even if only a little bit, is beginning to recognize the need to reward quality of care and prevention. This is a most welcome initiative by Medicare. Some state Medicaid programs have instituted similar initiatives, and private insurers are likely to consider following suit.

While some of the occurrences/conditions on the list certainly should never happen, sending a a baby home with the wrong parents for example, accidents do happen. We all make mistakes, and when we do, we must take responsibility. Now in the health care industry, at least from Medicare's perspective, the providers who make certain preventable mistakes are held accountable like the rest of us. None of us would pay our auto mechanic to replace the windshield he accidentally cracked while adjusting our brakes. And while this is probably a poor analogy, the underlying principal and policy is the same as that espoused by Medicare's recent policy change.

Hopefully measures like the one now in place at Medicare will proliferate and help to make our health care system safer and more efficient for everyone.

Full post as published by Cleveland Personal Injury Lawyer on October 03, 2008 (boomark / email).