- The Washington Times - Wednesday, October 6, 2004

MINNEAPOLIS (AP) — A Minnesota health insurer says it won’t pay the bill when doctors make serious mistakes — apparently the first time an insurer has taken such a hard-line stand against medical errors.

HealthPartners, Minnesota’s third-largest health insurer, said it is not trying to save money, but wants to send a message to get doctors to take medical mistakes seriously.

“This is about reinforcing accountability. We want to make sure that no person that experiences one of these events, as terrible and tragic as they are, has to suffer additionally by being billed for them,” said Dr. George Isham, HealthPartners medical director. “This is not going to have a major impact, or even a noticeable impact, on costs at all.”

Some doctors didn’t see it that way.

“He can say whatever he wants to say. What it really is about is HealthPartners not paying for medical care,” said Dr. Michael Gonzalez-Campoy, president of the Minnesota Medical Association.

He said the MMA has not yet taken a position on the company’s decision, but he thinks doctors would rather see a system that works to fix problems rather than simply not paying for them.

“To penalize financially individuals that in his mind are making mistakes is something that doesn’t happen in any other industry,” Dr. Gonzalez-Campoy said. “If you go to have your car fixed and they replace a part that they shouldn’t have, you’re still going to have to pay for the service.”

Karen Ignagni, chief executive of America’s Health Insurance Plans, said HealthPartners is the first insurer she’s heard of to refuse to pay for mistakes.

“The health care system has paid the same for good care and bad care, and I think the significance of this initiative is that it breaks that link,” she said.

HealthPartners, which has 630,000 customers, said its contracts won’t allow the hospital to bill the patient for the unpaid amount.

In a 1999 report, the Institute of Medicine estimated that 44,000 to 98,000 Americans die annually because of medical mistakes. Since then, 22 states have adopted laws requiring hospitals to report serious mistakes, according to the National Academy for State Health Policy.

The National Quality Forum, which sets voluntary hospital standards, developed a list of 27 mistakes such as amputating the wrong limb or sending a baby home with the wrong family. They’ve been dubbed “never” mistakes because they’re so serious they are never supposed to happen.

It is those 27 mistakes Minnesota hospitals must report. HealthPartners piggybacked on that procedure to require its providers to inform the company of any of the same mistakes within 10 days, beginning Jan. 1.

Dr. Isham said about 40 such mistakes have been reported under the state law during the first nine months. Some of those involved hospitals that contract with HealthPartners. But Dr. Isham said he didn’t know how many, if any, involved HealthPartners patients.

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