Schedule a Consultation | Toll Free: 1-800-678-1307
Trial lawyers specializing in personal injury and civil litigation

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.

Thompson O’Neil, P.C.
309 East Front Street
Traverse City, Michigan 49684
Toll Free: 1-800-678-1307
Fax: 231-929-7262