Medicare Buck Stops at Paying for Hospital Mistakes

WASHINGTON, Aug. 20 -- Medicare has told hospitals that they will soon be responsible on their own for the expenses that incur from many common preventable mistakes they make.

As of Oct. 1, 2008, Medicare will no longer reimburse hospitals for the extra costs of treating injuries from eight preventable conditions. Medicare officials said they plan to add three more conditions to the no-pay list next year.

The eight conditions are patient falls, pressure ulcers, urinary tract infections, vascular-catheter-associated infections, mediastinitis, air emboli, removal of objects lefts in the body during surgery, and injury caused by use of incompatible blood products.

Moreover, the rule change also prohibits hospitals from billing the patients for "any charges associated with the hospital-acquired complication."

The change in payment policy will help assure that "Medicare payments for inpatient services will be more accurate and better reflect the severity of the patient's condition," said Herb Kuhn, acting deputy administrator at the Centers for Medicare & Medicaid Services (CMS).

Starting on Oct. 1, hospitals will be required to report secondary admission diagnoses to CMS. A year later, CMS will begin checking those admission records against discharge diagnoses. When any of the eight conditions appear on discharge but not admission, CMS will refuse payment.

CMS has not said how much it expected to save once the new policy takes effect, but last year former CMS director Mark McClellan, M.D., Ph.D., said Medicare could save hundreds of millions if it stopped paying for medical mistakes.