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Reimbursement halted for 11 errors

Case Management Weekly, April 16, 2008

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Following Medicare’s lead, and possibly setting the stage for other insurance companies to do the same, WellPoint has declared it will stop reimbursement payments for 11 medical errors, all of which have been declared preventable by CMS. Wellpoint is the nation’s largest insurer in terms of members. Its subsidiaries include Anthem Blue Cross Blue Shield in several states. 

Some of the errors declared preventable, according to an article in The Indianapolis Star, are surgery performed on the wrong body part, UTIs associated with catheter use, and pressure ulcers. WellPoint says one of the methods used for discovering these errors will be comparing the diagnosis and status of the patient at the time of admission with the treatment received while in the hospital.

The company hopes to promote safe practices as well as save money from the program, which is expected to be implemented nationwide this year. The U.S. Centers for Disease Control and Prevention estimate that preventable infections contracted by hospital patients cost about $4.5 billion each year.

Source: The Indianapolis Star

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