CIGNA has become the latest health plan to pick avoidable conditions for which it won't routinely reimburse providers. Following CMS's lead, CIGNA has decided that it won't pay for standard "never events," including wrong-side surgeries, objects left inside a patient during surgery, air embolisms, use of the wrong blood type during transfusions, pressure ulcers and hospital-acquired injuries. In an important aside, the plan notes that it will only stop reimbursement for such conditions when it's permitted to do so under its hospital contracts, which should slow the rollout of its plans to some degree. In its statement on the subject, CIGNA also notes that patients should not end up being liable for these costs. However, as we've predicted previously, my guess is that patients will end up being embroiled in payment disputes, nonetheless, due to policies like this. Guess this is a "wait and see" thing.
To learn more about CIGNA's decision:
- read the company's press release
- read the Wall Street Journal blog item on this subject
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By 2008, Medicare won't pay for hospital errors