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Never Events’: Hospital Mistakes Medicare Won’t Pay for

When you go to the hospital, you hope your doctor will provide you with good care. But sometimes your treatment results in you being worse off than when you entered the hospital. Remarkably, though, when you suffer as a result of medical malpractice, hospitals still expect you to pay not only for the initial procedure, but also all the additional treatments you must suffer through to correct the mistake.

Soon, though, that may be a thing of the past.

Insurance companies have long been pressuring doctors and hospitals to acknowledge their own mistakes and pay for the complications resulting from them. Now, in October, Medicare is taking the next step: refusing to pay for complications that result from doctor and hospital mistakes, so-called never events because they should never happen. For now, the list of doctor errors includes eight events:

  • Surgical object(s) left in patient during surgery
  • Preventable air embolism
  • Complications from being given wrong blood type
  • Urinary-tract infections associated with catheters
  • Pressure ulcers (bed sores)
  • Infection associated with vascular catheters
  • Patient falls
  • Infection at the surgery site following coronary-artery-bypass graft surgery

In addition, Medicare plans to add more of these events it will not pay for every year. In addition, many insurance companies are also refusing to pay for complications related to these errors as well as dozens more included on a list of items compiled by the National Quality Forum, a membership organization formed to develop and implement a strategy for measuring and reporting health care quality. In addition to the above-named items, this larger list includes:

  • Surgery on the wrong body part or patient, or the wrong surgery
  • Postoperative death of a previously healthy patient
  • A patient suicide in the hospital
  • Death of the mother in a low-risk pregnancy
  • Brain damage as a result of jaundice in infants
  • Artificial insemination with the wrong sperm or egg
  • Delivery of wrong gas or toxic substances through an oxygen or gas line
  • Abduction, physical assault, or sexual assault of a patient

Many hospitals continue to charge for care relating to these obviously preventable outcomes, and not all insurance companies will help you fight against these charges. However, the culture is changing, and the stand taken by Medicare on this issue can only help.

To learn more about how these rules are changing and what it means for your medical malpractice claim in Orlando or anywhere in Florida, please contact the medical malpractice lawyers at Colling Gilbert Wright today for a free initial consultation.

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