IL Blue plan won't pay for errors

Blue Cross and Blue Shield of Illinois has become the latest Blue plan to roll out a policy banning payment for medical errors by hospitals. It's become one of several fellow Blue plans to announce such a policy in the wake of an announcement by the Blue Cross and Blue Shield Association last November that its affiliates would be introducing such rules. Plans in states including Texas, Massachusetts, Michigan and Rhode Island have already announced their participation in the initiative.

According to the health plan, it will work with hospitals to roll out the policy, but it hasn't yet defined which conditions and events will be addressed. More typically, health plans that make such an announcement have been modeling their policies after CMS's list of conditions and never events for which it won't reimburse. Never events, typically those named by the National Quality Forum, usually include wrong-side surgery or discharge of an infant to the wrong family.

This is part of a larger national movement emerging to support non-payment for never events and preventable conditions. For example, earlier this summer the trade group for California health insurers, the California Association of Health Plans, announced that it had passed a resolution in favor of no longer paying for CMS's list of never events, as well as three preventable mistakes.

To learn more about this trend:
- read this Modern Healthcare article (reg. req.)

Related Articles:
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