Medicaid To Stop Paying For Hospital Mistakes

[Ilsa]

http://www.kaiserhealthnews.org/Stories/2011/June/01/medicaid-hospital-medical-error-payment-short-take.aspx


Medicaid will stop paying for about two dozen "never events" in hospitals, such as operations on the wrong body part and certain surgical-site infections, federal officials said today.
Snip

"These steps will encourage health professionals and hospitals to reduce preventable infections, and eliminate serious medical errors," said Donald Berwick, administrator of the Centers for Medicare and Medicaid Services. "As we reduce the frequency of these conditions, we will improve care for patients and bring down costs at the same time."

Some physician groups have concerns about the new policy. "Simply not paying for complications or conditions, that, while extremely regrettable, are not entirely preventable, is a blunt approach that is not effective or wise for patients or the Medicare or Medicaid program," Dr. Michael Maves, CEO of the American Medical Association, said in written comments to CMS in March.

Snip


This is list of preventable conditions that Medicaid will no longer pay for:

Foreign Object Retained After Surgery
Air Embolism
Blood Incompatibility
Stage III and IV Pressure Ulcers
Falls and Trauma
Fractures
Dislocations
Intracranial Injuries
Crushing Injuries
Burns
Electric Shock
Catheter-Associated Urinary Tract Infection (UTI)
Vascular Catheter-Associated Infection
Manifestations of Poor Glycemic Control
Diabetic Ketoacidosis
Nonketotic Hyperosmolar Coma
Hypoglycemic Coma
Secondary Diabetes with Ketoacidosis
Secondary Diabetes with Hyperosmolarity
Surgical Site Infection Following:
Coronary Artery Bypass Graft (CABG) - Mediastinitis
Bariatric Surgery
Laparoscopic Gastric Bypass
Gastroenterostomy
Laparoscopic Gastric Restrictive Surgery
Orthopedic Procedures
Spine
Neck
Shoulder
Elbow 
Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE) Following Total Knee Replacement or Hip Replacement – with pediatric and obstetric exceptions
Surgery on the wrong patient, wrong surgery on a patient, and wrong site surgery
Source: CMS

[Tippy]

1. Long over due in my book...

[Jackpine Radical]

2. The response of Big Medicine:

Entirely predictable.

Leave the stray forceps in the body unless the patient agrees to pay for its removal.

[Donnachaidh]

4. or go after the patient with the wrong limb removed to pay for the services

Doesn't matter they fucked up -- they got's to be PAID, dammit!

[SharonAnn]

Only problem is that hospital won't to treat patient to correct the problem, if the can.

For profit hospitals will find a way to avoid the cost of treating the patients who have been injured in the above ways.

There will need to be some safeguards or the patients will have to have some kind of legal redress that's automatic, not years of delay and legal motions before a decision.

[Amaril]

3. I've never agreed with hospitals / physicans billing........

.....patients -- vis-a-vis their insurance plan -- to fix a mistake THEY made.

If I take my car to a mechanic to replace my carburator and he/she breaks my windshield, should I have to pay for it because it was a "foreseeable complication"? Yeah, I think not.

[bbgrunt]

5. so where does that leave patients who suffer these problems?

[bbgrunt]

6. Maybe I am just dense, but I fail to see how

Orthopedic Procedures
Spine
Neck
Shoulder
Elbow

is in any way reducing "errors" or preventable mistakes. Does this simply mean that medicare will no longer pay for such procedures?

[madrchsod]

7. i think medicare does`t pay for preventable hospital mistakes.

[kestrel91316]

9. This makes it sound like they simply don't pay for a whole laundry list of conditions.

So patients with these conditions will be billed when they already HAVE NO MONEY and will be sued into bankruptcy.

But wait, you can't bankrupt out of medical bills anymore. So their wages, if any, will be garnished and they will be forced into homelesness and literal starvation.

Explain to me again what the point of Medicaid is???

[madrchsod]

10. when was the law changed?

i filed bankruptcy on my medical bills 2yrs ago...student loans and some taxes are never written off in bankruptcy. just about everything else is if it`s all kosher

[kestrel91316]

8. Deleted - I can't read, obviously