Medicaid is about to stop paying hospitals when they make certain kinds of mistakes. This new federal law will take effect in all states by 2012. It is similar to a Medicare law that has been in place since 2008. The purpose is to drive down the costs to the Medicaid program, and to improve the quality of care that is given to patients.
Medicaid is a program that is administered by both the federal government and individual state governments. It is designed to be used by people who are disabled, and people whose annual income is extremely low. A new law has been created that specifies that Medicaid funds will no longer be used to pay either doctors or hospitals for mistakes that are being called “never events”.
This new law is very similar to a Medicare regulation that was created in 2008. States will have until 2012 to implement this new policy. The two laws together should make Medicare and Medicaid a bit more coordinated with each other.
The main purpose of the regulation is to improve the quality of the health care that people who are using the Medicaid program are receiving. The other focus is to lower the costs that the Medicaid program is paying out. When a similar law was enacted with the Medicare program, it did end up saving a lot of money.
As far as this new regulation is concerned, a “never event” refers to mistakes made by doctors or hospitals that should not have been made. It also refers to health care services that “resulted from certain preventable health care-acquired illnesses or injuries”.
Some of the preventable conditions that Medicaid is no longer going to pay doctors or hospitals for include: blood incompatibility, air embolism, or if the patient has a foreign object retained after surgery. It will not pay for surgery that was done on the wrong patient. It won’t pay for the wrong surgery that was preformed on a particular patient, and it also won’t pay for surgeries done on the “wrong site”.
Sometimes, people actually become injured while at the hospital. Medicaid will no longer pay for falls and traumas, fractures, dislocations, intracranial injuries, crushing injuries, burns, or electric shock that a patient suffers while at the hospital.
Other problems can arise when a patient does not get the proper care that he or she needs from the doctor or hospital. Medicaid will no longer pay for catheter-associated urinary track infections (UTI), vascular catheter associated infections, or surgical site infections. There are several health issues that relate to mistakes made with a diabetic person that will also not be paid for any longer.
Overall, the hope is that since hospitals won’t be paid for these kinds of mistakes, they will impress upon their doctors and staff the importance of making sure those things do not happen. This should improve the health care that all patients receive.
Image by Scott Zona on Flickr