New York Medicaid to Stop Paying for Hospital Mistakes

New York state Medicaid officials have announced that beginning in October 2008, the program will stop paying for 14 avoidable hospital errors. The list includes such mistakes as performing surgery on the wrong patient, performing the wrong surgical procedure on the right patient, and medication errors. The officials believe that the 14 errors should never occur in patient care. The state expects to save $6 million from October through the end of the year.

Two other states, Pennsylvania and Maine have also taken steps to cease Medicaid payments for hospital errors. The Pennsylvania guidelines take a somewhat different approach than those of New York. In New York the hospital providers are not permitted to bill for any of the errors. In Pennsylvania the commonwealth will select bills that officials wish to investigate more closely. Then medical experts will review the claims to determine whether hospitals committed errors. While the New York model restricts the filing of claims, the Pennsylvania model allows billings that may result in the denial of payment. Legislatures in California and Connecticut are also considering restricting Medicaid payments for hospital errors.

It is likely that other states will follow the lead of New York and sister states in restricting Medicaid claims or payments for hospital errors.

For an article on the issue, please see Modern Healthcare, “N.Y. Medicaid Ups the Ante,” p.6, June 16, 2008.

About Richard Serafini

Welcome to my blog. I am an attorney and practice in the area of corporate trial work. Areas of particular emphasis are white collar defense, securities litigation, health care litigation, internal investigations, RICO, and financial litigation. I will be posting interesting developments in my areas of interest. I hope that you find this blog helpful and informative.