Twenty-three states adopt no-pay policy

A recent MSNBC.com article reports that hospitals in 23 states have adopted CMS’ no-pay policy for hospital-acquired conditions (HACs). That number has increased significantly since February, when hospital associations in only 11 states had adopted the policy.

The no-pay policies for the hospitals in these 23 states apply to specific conditions. Meanwhile, hospitals in an additional eight states have agreed to general guidelines that advise eliminating bills on a case-by-case basis for errors proven to be both serious and preventable, according to the article.

Some hospital executives quoted within the article argue that no-pay policies are not always fair to hospitals, since some conditions that occur are not within the control of the clinicians at the organization.

"Just because something defacto occurred on that list, that doesn’t mean that it's defacto the fault of the provider," said Karen Nelson, senior vice president for clinical affairs at the Massachusetts Hospital Association. ...

Some of the conditions on the lists kept by NQF and Medicare may not be preventable or under the hospital's control, added Dr. Dan Stultz, president of the Texas Hospital Association, which announced a new policy last month that recommends not billing for nine preventable errors.

"ABO blood compatibility? I don’t have a problem with that," Stultz said. But if a titanium medical device fails because of a manufacturing defect, the hospital shouldn’t be held responsible, he added.