Monday, August 20, 2007

Medicare Pulls the Plug

Medicare will stop paying the costs of treating infections, falls, objects left in surgical patients and other things that happen in hospitals that could have been prevented.

One one hand, I agree. Why should the taxpayer pay for things where the hospital (or other negligent party) is clearly liable.

On the other hand, who is going to decide the liability issue? Are the hospitals going to readily admit their wrong? Will the patient be caught in the middle?

"Our efforts in this arena and in other payment rules are to ensure that CMS is an active purchaser, not passive payer, of health care,"

That should be the case with any payor. It doesn't matter if the payor is the taxpayer, the carrier or the individual.

Hospitals in the future will be expected to pick up the cost of additional treatment required by a preventable condition acquired in the hospital.

"The hospital cannot bill the beneficiary for any charges associated with the hospital-acquired complication," the final rules say.

This implies that hospitals could bill CMS with impunity in the past. Who made this rule?

Last year, Mark McClellan, then director of the Medicare and Medicare programs, said the government could save hundreds of millions of dollars a year if the Medicare program stopped paying for medical errors such as operations on the wrong body part or mismatched blood transfusions.

Operations on wrong body parts. I don't want to go there.

Private insurers are considering similar changes.

And they should . . .
blog comments powered by Disqus