Medicare Won't Pay for Hospital Surgical Mistakes

If the surgeon leaves a sponge inside a patient during surgery, Medicare will no longer pay for the costs associated with correcting the problem. Beginning this month, Medicare will not pay for the correction of medical errors. Experts are hoping that this change helps reduce the number of surgical mistakes and increase the quality of care.

Medicare identified 10 conditions that are “reasonably preventable,” in which hospitals will no longer be reimbursed. The government agency believes that these conditions are the direct result of poor hospital care. The conditions listed include situations such as leaving a foreign object inside the patient after surgery, incompatible blood transfusion, bed sores, air embolism, falls, urinary-tract infections caused by catheters, surgical infections, vascular infections from catheters, poor glycemic control and pulmonary embolism. Medicare did not include “never events” in the list of conditions, which are circumstances that should not have happened in the first place, such as removing the wrong limb.

Patients will also not be required to reimburse the hospital for these conditions. The financial burden will instead be placed on the hospital. Many insurance companies are also following Medicare’s example and have listed conditions that they will no longer pay for as well.

Even though Medicare will not save a significant amount of money by not reimbursing hospitals for certain conditions, the theory is that there will be an overall higher savings by reducing unnecessary treatments resulting from medical errors. It is estimated that Medicare will save $12 million of the $110 billion spent on in-patient hospital care annually.

Recently, Medicare also started a public reporting system of hospitals’ performance levels. Officials feel that these initiatives will pressure hospitals to improve quality and safety within their facilities.

If you have been harmed by a surgical mistake or hospital error, contact law offices of Lilly, O’Toole & Brown, LLP at (863) 683-1111 to speak with a Florida medical malpractice attorney.

The article, Hospital Surgical Mistakes Not Covered by Medicare, has more information about Medicare’s new initiatives.