Costs tied to wrongful surgeries, medication errors not charged to patients in Utah

Heather May

Aug. 19, 2008 (McClatchy-Tribune Regional News delivered by Newstex) -- Wrong-site surgeries and major injuries from medication errors are so unacceptable that Utah hospitals will not charge patients for the care it takes to fix the mistake.

Every Utah hospital agreed to the payment policy on so-called never events this summer, according to Debra Wynkoop, director of health policy for the Utah Hospitals and Health Systems Association. "It's the right thing to do."

Patients will be billed for the original reason they went to the hospital, she noted. But if they need subsequent care because of a serious hospital error -- if a patient falls, develops major bed sores or is burned, for instance -- that care will not be charged.

It's part of a national trend for hospitals, insurance companies and the federal government to refuse to pay for preventable medical mistakes. In 2007, there were 57 never events, the most serious medical errors, reported in Utah hospitals surgical centers.

The federal Centers for Medicare and Medicaid recently expanded the list of hospital-acquired conditions for which it will not pay facilities for the extra cost of treating. These new rules start in October. They include things such as blood clots that form after knee or hip replacements, complications from poor control of blood sugar levels and foreign objects accidently left after surgery.

The centers urged state Medicaid directors to consider similar policies. Utah is studying it. So are some of the state's large private insurance companies.

"We're watching what Medicare is doing, along with everyone in the country, to see how this will develop," said Jason Burgess, spokesman for SelectHealth.

Regence BlueCross BlueShield of Utah plans to make a decision soon, though it noted it cannot track such errors as they occur.

In other states where commercial insurers have decided not to pay, patients are "held harmless" -- meaning facilities do not pursue payment from individual patients for care that resulted in a serious medical error, or for the required follow-up care.

hmay@sltrib.com

Newstex ID: KRTB-0192-27517889