Medicaid Refuses to Pay for Serious Medical Mistakes Caused by Negligent Doctors

It is an unfortunate reality in our nation’s healthcare system that preventable medical errors kill hundreds of thousands of Americans every year. Our Illinois medical malpractice attorneys have seen far too many innocent patients suffer the devastating consequences of medical mistakes caused by negligent hospital employees. Now federal officials are stepping in to try and reduce the most serious medical errors, which are called “never events” because they are so shocking that they should never occur under any circumstances. On July 1, 2011, Medicaid will stop paying for more than two dozen “never events” in hospitals nationwide. The goal is to financially discourage doctors from committing careless medical mistakes resulting in catastrophic patient injuries.

Our medical negligence lawyers are encouraged by several aspects of this new rule. Not only does it prohibit states from reimbursing negligent health-care providers, it also expands the list of preventable medical conditions that Medicaid will not cover. Currently, 28 events are considered to be “never events,” including operating on the wrong patient, performing the wrong procedure, or leaving a foreign object in a patient’s body. These preventable mistakes lead to an alarming number of serious problems or death. The Institute of Medicine estimates that these errors kill nearly 100,000 people a year and severely injure thousands of others.

In addition to these grave mistakes, states will have the flexibility to add more injuries to the list of preventable medical The latest regulation is part of an ongoing effort by federal and state governments to improve poor patient hospital care. In 2007 Medicare instituted a similar regulation protecting the elderly patients. Also, private insurers have adopted policies that prohibit reimbursements for complications that should never occur in a hospital setting. In Illinois, one of the first states to create a “never event” law, hospitals must report and take corrective action for all medical mistakes. Unfortunately, simple, preventable mistakes continue to happen on a regular basis. The Joint Commission Center on Transforming Healthcare recently reported that at least 40 wrong site or wrong patient procedures happen every week. Even more disturbing is that fact that more than 60 percent of these “never” events lead to a fatal result. No patient is immune from harm.

Even a high-powered Chicago executive fell victim to a fatal medical error at the prestigious University of Chicago Medical Center. James Tyree, the Chicago Sun-Times CEO, died in April after doctors at the hospital removed his catheter incorrectly while treating him for pneumonia. An air bubble went into Tyree’s bloodstream, leading to his wrongful death. This is a clear example of the type of gross negligence that is occurring in hospitals each and every day. Although penalizing hospitals for medical negligence is one way to improve patient safety, it still may not be enough to end this horrific epidemic of medical malpractice.

The Chicago Tribune reports that medical mistakes cost more than just a human toll, they also account for a significant portion of annual taxpayer dollars. A November 2010 report by the U.S. Department of Health and Human Services found that adverse hospital events cost more than $4.4 billion a year. Reducing preventable mistakes will drive down overall healthcare costs.

Refusing to pay for “never events” may encourage doctors to avoid acting negligently, but Illinois medical malpractice attorneys at Pintas & Mullins Law Firm know that the justice system is the most effective way to hold the medical community accountable for medical errors. Not only do lawsuits deter negligent doctors and hospitals, they also help compensate victims of medical mistakes for their pain and suffering. Dangerous doctors compromise patient safety and drive up health care costs for everyone.

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