The Texas Hospital Association (THA) joined at least a dozen other state hospital associations in adopting guidelines for its member hospitals addressing the application of voluntary discounts or waivers of patient payment obligations associated with medical errors or adverse events. At least one health plan, Blue Cross and Blue Shield of Texas, has notified THA that it will base its reimbursement guidelines on THA's principles.
Since adopting the guidelines in mid-May, THA has encouraged its member hospitals to adopt the principles. Several principles for adoption were identified in THA's press release including the following (1) the error or event must be preventable and within the control of the hospital; (2) the error or event resulted from a mistake made in the hospital; and (3) the error must result in significant harm and be something that can be clearly and precisely defined in advance.
Nine specific examples were provided in which nonpayment would be considered appropriate, including:
- Surgery performed on the wrong body part
- Surgery performed on the wrong patient
- The wrong surgical procedure performed on a patient
- Patient death or serious disability associated with intravascular air embolism occurring in the hospital
- An infant discharged to the wrong person
- Patient death or serious disability associated with a hemolytic reaction due to the administration of ABO-incompatible blood or blood products
- Death or serious disability, including kernicterus, associated with failure to identify and treat hyperbilirubinemia in neonates during the first 28 days of life
- Artificial insemination with the wrong donor sperm or donor egg
- Patient death or serious disability associated with a burn incurred from any source while being cared for in a facility.
THA's actions represent a growing national trend focusing on the elimination of medical errors, transparency among healthcare providers relating to medical errors, and the best manner for providers to address quality within their respective institutions.