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Major Health Carrier Announces it Won't be Paying for Botched Surgeries

April 3, 2008

April 2, 2008

WellPoint won't pay for botched surgeries

By Tom Spalding, Indianapolis Star
WellPoint has come up with a new way to protect patients from having a routine surgery go awry.

It won't pay for them.

The Indianapolis-based health insurer today said it has informed hospitals that service WellPoint's 35 million members that it won't pay the hospitals for medical errors in 11 scenarios, including surgery on the wrong body part or for an object or medical instrument left in the body during surgery.

Other boo-boos that won't be tolerated: catheter-associated infections and hospital-acquired injuries such as fractures, dislocations, crushing injuries and burns.

WellPoint says its stance should save money, since medical professionals will have to be extra careful. Avoidable errors will now carry a price tag.

""Our primary focus is to help ensure that physicians and hospitals are using appropriate processes, technologies and strategies to address 'never events' and ultimately to enhance the quality of care delivered to hospitalized patients,"" said Sam Nussbaum, WellPoint executive vice president of clinical health policy and chief medical officer.

In a news release, the president of the National Patient Safety Foundation praised WellPoint's initiative, which is in its first stage. Diane Pinakiewicz called the move ""commendable"" and a proactive way of ensuring patient safety.

One client is already praising WellPoint for its stance.

""It is critical that the entire health care system be looking for ways to improve safety and reduce harmful medical mistakes,"" said Bruce E. Bradley, a General Motors health care director says. GM thanked WellPoint for ""implementing policies to help eliminate these costly adverse events."