Medicare refuses to pay for hospital mistakes

Starting on Wednesday, Medicare will begin refusing payment to medical providers who have negligently caused a patient to suffer medical expenses. This change in policy was described in an earlier weblog entry, but basically identifies 10 "reasonably preventable" conditions, initially, which will result in non-reimbursement.  The conditons identified by Medicare include incompatible blood transfusions, certain post-surgical infections, and retrieval of foreign objects, post surgery.  It also includes serious bed sores, fall injuries and infections of the urinary tract caused by in-dwelling catheters. 

An HMO in Minnesota was the first insurer to adopt a similar policy.  Medicare's decision in this regard has reportedly influenced other insurers to deny payment for negligently-incurred costs.  The State of New York now denies payment for 28 so-called "never events".  The Institute of Medicine estimated in 1999 that 44,000 to 98,000 Americans die each year from preventable medical errors.  Most authorities believe that a non-pay policy does not generate large savings directly, but that by encouraging a renewed focus on patient-safety, it generates significant indirect savings for insurers.