Medicaid will not cover errors in Pa.

Taxpayers will no longer pick up the tab for extra care due to serious preventable hospital errors, Gov. Rendell said yesterday, a move that continues Pennsylvania's status as a leader of the growing national push to reduce mistakes in health care.

The state Department of Public Welfare launched a program last week to identify and stop Medicaid payments to hospitals when patients are seriously injured by mistakes. The policy also prohibits hospitals from passing the charges on to patients.

The agency will review hospital bills for 27 so-called never events, such as operations conducted on the wrong patient, medication errors that result in death or disability, and bad blood transfusions.

"This is another milestone in improving the quality of care," Estelle Richman, secretary of the Department of Public Welfare, said at a news conference in Harrisburg yesterday.

Pennsylvania is among a handful of states, including Minnesota and Massachusetts, to enact such measures.

Last year the federal government identified eight types of errors that Medicare, the health-care program for the elderly, would stop paying for on Oct. 1. Medicaid, which mainly covers the poor, is funded jointly by Washington and the states.

"There is a growing concern nationally over health-care quality and how taxpayer dollars are being used," Laura Tobler, a health-policy analyst at the National Conference of State Legislatures, said yesterday. "Pennsylvania has been a leader in developing policy to reduce errors and improve the quality of health care," she said, adding that other states would be watching what happens here.

New Jersey currently has no plans to follow suit.

"We want to monitor Medicare's initiative and, if it is feasible, we will explore it as a way to improve the quality of care," said Suzanne Esterman, a spokeswoman for the New Jersey Department of Human Services.

Jeff Van Ness, a spokesman for the National Committee for Quality Assurance in Washington, said it was important to align payments with quality of care.

Pennsylvania is taking "a good step in that direction" but more needs to be done, he said, such as paying hospitals for actions like aggressive infection-control efforts that improve quality and reduce mistakes but that are not typically reimbursed by government or private insurers.

Hospitals in Pennsylvania worked with state officials over the last eight months to develop the new error policy and ensure that it was fair and created incentives to improve care.

"We are trying to do everything possible to eliminate these events," said Ken Braithwaite, head of the Delaware Valley Healthcare Council, which represents hospitals in the region. "But until we eliminate them, we as a hospital community don't think we should be paid for them."

The initiative is part of Rendell's broader health-care plan announced last January. The aim is to improve the quality of care, reduce errors, eliminate so-called hospital-acquired infections, and make affordable health insurance available to the nearly 800,000 uninsured Pennsylvania adults.

Yesterday, Rendell also announced that 29,000 uninsured people on the waiting list for the state's low-cost adultBasic insurance program would get coverage.

The governor chided legislators for failing to act on his proposal to expand access to health coverage, saying that if the General Assembly had approved it last year, 70,000 more people would now be insured.

"We could have pretty much wiped out the waiting list," Rendell said in a statement, adding that "it would have allowed us to start to make a dent" in the number of uninsured in Pennsylvania.

The governor didn't need legislative approval for Medicaid to stop paying hospitals for care resulting from errors.

Under the initiative - which applies to care in acute-care hospitals since Jan. 14 - the state will assess each case of a possible error, looking for events that were preventable, within the hospital's control, and that resulted in significant harm.

"Too often we learn that during an extended hospital stay, patients have received care that poses serious and sometimes fatal health risks," Rendell said.

"Through this initiative, we are taking steps to ensure that payment for services through the medical assistance program is made to hospitals based on their efforts to provide quality care."

Text of the new policy and related information: http://go.philly.com/healthEndText