Blue Cross and Blue Shield of Illinois announced it will no longer pay for costs related to medical errors, including hospital-acquired conditions and mistakes known as never events.
The Blues have been rolling out their no-pay policies since early 2008, after the Blue Cross and Blue Shield Association said during a November conference the plans would be implemented across the country. Illinois joins other Blues plans, including Massachusetts, Michigan, Rhode Island and Texas, which made similar announcements recently.
The insurer will work with hospitals to implement its plan, but at this point it has not defined which specific conditions and never events will be covered, an Illinois Blues spokeswoman said. Other Blues plans, in addition to other insurers that have announced no-pay policies, model their lists after the CMS list of conditions and errors for which it will stop reimbursing starting Oct. 1. Never events typically include errors named by the National Quality Forum as events that should not ever occur in a hospital, such as wrong-site surgery or discharging an infant to the wrong family. Hospital-acquired conditions mostly refer to problems that develop following a medical procedure, such as catheter-related urinary tract infections and pressure ulcers.
The CMS announced last week its non-reimbursement list will be expanded to include three more conditions: surgical-site infections following certain surgeries, poor control of blood sugar levels and deep-vein thrombosis or pulmonary embolism following total hip or knee replacement. -- by Jean DerGurahian