Medicare to Stop Paying for Hospital Errors

Several news outlets including an August 19, 2007 article in the New York Times has reported that a U.S. governmental change will have a profound change on Medicare and those who use it. As of October 1, 2008, Medicare will no longer pay hospitals for treatment for problems caused by what they termed “preventable medical errors”. This change will stop payment for care for such things as injuries, as well as bedsores, pressure ulcers; injuries caused by falls, and infections resulting from the prolonged use of catheters in blood vessels or the bladder.

The articles tout this change as a potentially large savings to the Medicare system and to patients. They also speculate that private insurance companies may also follow the lead of Medicare and institute similar policies. Herb B. Kuhn, acting deputy administrator of the centres for Medicare and Medicaid Services explained the reasoning by saying, “If a patient goes into the hospital with pneumonia, we don’t want them to leave with a broken arm.”

The Times article reports that according to the U.S. centres for Disease Control and Prevention (CDC) approximately 1.7 million patients develop infections in hospitals each year, and the CDC estimates that those infections cause or contribute to the death of 99,000 people a year which is about 270 a day.

Lisa McGiffert, a Senior Policy Analyst for “Consumers Union”, a Non Profit Publisher of Consumer Reports, weighed in by stating, “Every year, millions of Americans suffer needlessly from preventable hospital infections and medical errors. These new rules are a good beginning for Medicare to use its clout to mobilize hospitals to improve care and keep patients safe.” Ms. McGiffert commented in the Times article, “Medicare is using its clout to improve care and keep patients safe. It’s forcing hospitals to face this problem in a way they never have before.”

Other officials who applaud the upcoming change include Christine K. Cahill, a registered nurse who used to inspect hospitals for the California Department of Public Health. She said: “This is a great start. Infection-control specialists have been screaming for 20 years that federal and state officials should pay more attention to this problem because hospital infections hurt patients and cost money.”

The Times article does note that patients will not get stuck with the bill if Medicare refuses to pay for care related to preventable errors. The article notes that the new rules states, “The hospital cannot bill the beneficiary for any charges associated with the hospital-acquired complication.”