Preventable Medical Errors: Neither Insurance Nor Patients Should Pay

 Medicare, the largest insurance provider in the country, announced on October 1, 2008,  that it will no longer be financially responsible for the costs of hospital’s medical errors, nor will these costs be pinned on patients themselves.

 According to a study by The Institute of Medicine, conducted in 1999, preventable medical errors cause the deaths of 44,000-98,000 people each year. These deaths are the result of many preventable errors dealing with misdiagnosis, improper treatment, and inadequate preventative care.

The following are just some of the errors that Medicaid will no longer pay for:

  • Incompatible blood transfusions
  • Development of infections after certain surgeries
  • A second operation to retrieve a sponge left from initial operation
  • Serious bed sores
  • Injuries from certain falls
  • Urinary tract infections caused by catheters

Surprisingly, this new enforcement offers little financial benefit to the insurance companies, according to a The New York Times report. Instead, the new rule is acting as a catalyst to move medical professionals in the direction of preventative care. This step is hoped to support the transition from focusing on quantity of care to focusing on the quality of medical care.

The Medicare Payment Advisory Commission, which advises Congress on medical issues, recently recommended that payments to some hospitals be reduced if those hospitals experience high readmission rates. Furthermore, Medicare is offering bonuses to hospitals that merely report their quality measures, yet another incentive for hospitals to become more accurate.

The approach Medicare is taking has been adopted by other insurance companies: both private and public and even by some state laws. Maine was the first state to ban payment for hospital error all together and at least 20 states have laws requiring hospitals to report to the public if they make a preventable mistake.

The new stance seems to be effective. Some hospitals are taking initiative by collaborating with each other; trying to discover common problems they all face and discussing possible solutions to them.

Previously on the DC Metro Area Personal Injury Law Blog, we have posted articles related to:

  • Negotiating Claims with Your Insurance Company: Helpful Tips
  • "Deny, Delay, Defend" Strategy Prevalent Among Ten Worst Insurance Companies: Comprehensive Investigation Reveals Tactics Against Consumers
  • Defendants Can No Longer Compel Settlements To Be Secret

For information about your legal rights, please click here or call the law firm of Regan Zambri & Long, PLLC at 202-463-3030.    

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