Drug Topics - April 7, 2008 - (Page 4) 4 DRUG TOPICS APRIL 7, 2008 www.drugtopics.com Of Interest to Pharmacists These hospitals are no longer charging patients for errors Michael Barbella purred by federal efforts to eliminate egregious medical errors, a growing number of hospitals throughout the nation are no longer charging patients and their insurers for serious, avoidable mistakes. Hospitals in at least 11 states have agreed to waive fees for certain errors called “never events” by healthcare experts. These events—so named because experts believe they should never happen—include medication errors, catheter-caused urinary tract infections, falls, bed sores, objects left in the body after surgery, embolisms, and blood incompatibility. “One adverse health event is too many,” Minnesota Hospital Association President Bruce Bruce Reuben Reuben said. “Our highest prioriPresident, ty is to eliminate preventable erMinnesota Hospital Association rors in healthcare delivery. Until that happens, patients can have confidence they will never have to pay for care made necessary by an adverse event.” Minnesota set the example for the rest of the nation last fall, when it established a statewide billing policy for care that holds hospitals financially responsible for specific “adverse health events.” Minnesota based its policy on more than two dozen “adverse” health events outlined by the National Quality Forum (NQF), a healthcare safety advocacy group based in Washington, D.C. “Adverse” events identified by the NQF and included in Minnesota’s policy include medication errors, “wrong-site” surgical procedures, discharging an infant to the wrong mother, a patient suicide or attempted suicide, patient death or serious disability resulting from a burn, patient death or serious disability resulting from the use of restraints or bedrails, and artificial insemination with the wrong donor sperm or wrong egg. S “One adverse health event is too many.” with medication errors and other mishaps. The policy prohibits hospitals from charging patients for any subsequent care needed to manage the mistake. Vermont wasn’t far behind Massachusetts in adopting a policy to waive fees for certain medical mistakes. The Vermont Association of Hospitals and Health Systems (VAHHS) unveiled its plan in January, outlining eight “very rare but serious” events, including injuries associated with medication errors and other untoward events. Pennsylvania jumped on the bandwagon in late January and became the first state in the nation to adopt a policy that withholds Medicare reimbursements to hospitals that fail to keep patients safe from preventable medical errors. In neighboring Delaware, patients can expect not to be charged for medical mistakes, and a “no-charge” policy is pending approval in West Virginia. Other states, however, are taking a “wait-and-see” approach: Illinois and Colorado are considering nonpayment policies, while New Jersey is examining such plans to determine whether it would be “feasible” to implement them. Federal deadline looming Pennsylvania’s new policy mimics a directive handed down last summer by the Centers for Medicare & Medicaid Services that is scheduled to take effect Oct. 1. Under that directive, CMS will no longer reimburse hospitals for the costs of certain preventable conditions, such as mediastinitis after coronary artery bypass graft or vascular catheter-associated infections. Hospitals also will no longer be allowed to bill patients for the cost of care. Next year, Medicare will add three additional errors to the no-pay list. The top candidates include drug-resistant staph infections and ventilator-caused pneumonia. Medicare’s directive also has prompted health insurers to negotiate similar policies with hospitals. Blue Cross Blue Shield officials, for example, hammered out a voluntary deal with the South Carolina Hospital Association. Under that agreement, the association’s member hospitals will no longer charge Blue Cross Blue Shield for 10 preventable errors. Aetna Inc. and WellPoint Inc. are looking to make similar deals. THE AUTHOR Follow the leader Since announcing its first-in-the-nation policy change in September, other states have followed Minnesota’s lead. In November, the Massachusetts Hospital Association announced its intention to adopt a policy there for hospitals to waive charges for serious adverse events. The policy, which became effective earlier this year, covers nine adverse health events, including injuries associated is a writer based in New Jersey. http://www.drugtopics.com
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