Monday, August 20, 2007

Will Medicare Rule Changes End Up Costing the Patient?


Medicare will no longer pay the extra costs of treating preventable errors, injuries and infections that occur in hospitals. The move will save medicare millions of dollars. (Private insurers are likely to make similar changes.) Medicare will no longer pay hospitals for the costs of treating “conditions that could reasonably have been prevented.”These conditions include bedsores, pressure ulcers, injuries caused by falls, and infections from prolonged use of catheters. Medicare also will no longer pay for treatment of “serious preventable events” like hospital fall downs, leaving a sponge in a patient during surgery or providing a patient with incompatible blood. Herb B. Kuhn is the acting deputy administrator of the Centers for Medicare and Medicaid Services. Hospital executives question who will pay the costs of these extra tests and services if Medicare does not. (Can you feel someone reaching into your pocket book?)
1.7 million infections develop in hospitals each year. Infection causes or contributes to the death of 99,000 people a year. Susan M. Pisano, America’s Health Insurance Plans, said, “Private insurers will take a close look at what Medicare is doing, with an eye to adopting similar policies.” Some fear that some hospitals will try to pass on the costs to patients. That is technically forbidden. “The hospital cannot bill the beneficiary for any charges associated with the hospital-acquired complication,” according to the Medicare rules. However, Dr. Kenneth W. Kizer, who was the top health official at the Department of Veterans Affairs from 1994 to 1999, said: “I applaud the intent of the new Medicare rules, but I worry that hospitals will figure out ways to get around them."


Only time will tell if this will hit the consumer in the pocketbook or lead to poorer health care.

11 comments:

Ann said...

"Not covered, can't treat" I can hear it now.

blond bombshell said...

Ok, Ann. You were the first one brave enough to say it. The hospital is going to stick the patient one way or another for the extra expense.

I am more than a bit concerned.

Shell

ralph said...

I already got holes in my pocket from the health care bandits!


Ralph

kyle said...

I can't see how this will help the patient. Either they will die from lack of treatment for non-covered problems or the costs will be passed on as hidden costs etc.



Kyle

Jooe P. said...

I felt a pain in the pit of my stomach and had to check my pocket book, because I have a feeling this rule change is going to drain folks like me.

Joe P.

Pete said...

It is all about medicare fraud. This is just trying to prevent paying for the health care providers unnecessary tests and mistakes...

Ms. Calabaza said...

We'll pay for it.

Dollar Bill said...

Some how I just don't trust this reform. So medicare saves millions, the hospitals will have to make it up some where!


Dollar Bill

Anonymous said...

But reform is good...

colleency said...

Let me see if I understand this -

health care costs are rising in part because of escalating malpractice rates resulting (in part) from exorbitant settlements .. But now Medicare (and soon other insurance companies) won't cover the cost of care resulting from mistakes ... so consumers will be forced to sue for just compensation .. causing-malpractice rates to go even higher ...

I think I've fallen through Alice's looking glass.

If I were a cynic, I might think that 'they' are making healthcare ever more expensive and nonsensical so that nationalized healthcare will look like the better option. Yup, some of the insurance companies would lose out - but there would be one mighty big winner.

Legal Pub said...

I think your analysis is correct. Hospitals will bill for the preventable conditions, Medicare will deny. Hospitals will likely pass the bill on to the consumer one way or the other. Consumers will already have a review from medicare that the treatment was for a preventable condition or because of a mistake. End result, it will likely motivate malpractice claims against the health care provider.

Good pick up, Colleency.