Following the lead of individual hospitals and associations around the U.S., the Texas Hospital Association has developed a policy designed to help its member hospitals determine when not to bill for care related to serious medical mistakes. The group's five "guiding principles" include that the error or event must have been preventable, within the control of the hospital, the result of a mistake made within the hospital, result in significant harm, and have been defined clearly and precisely in advance of the incident. The Association also included nine examples of non-payment events, including wrong-body-part surgery, wrong surgical procedure, infant discharged to the wrong patient, or patient death or disability due to a reaction to wrongly-used blood products. In creating this policy, the THA seems to be nudging health plans along, too. For example, Blue Cross and Blue Shield of Texas has already decided to base reimbursement on these principles.
To learn more about the policy:
- read this Modern Healthcare article (reg. req.)
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