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Cigna the latest to say it won't pay for preventable medical errors

By Fred Bazzoli

Another insurer has said it will no longer pay for hospital treatment required after egregious mistakes made by hospital staff.

Cigna HealthCare announced it is taking steps to stop reimbursing hospitals for so-called "never events" and avoidable hospital conditions.

Cigna said it is following the lead of other major payers, notably the Centers for Medicare & Medicaid Services.

CMS has already announced that it would not reimburse providers if beneficiaries suffer from eight preventable in-hospital errors beginning October 1. The agency reported last week that it was planning to increase the number of never events for which it wouldn't pay in fiscal year 2009.

The original list of never events consists of objects left in the body during surgery, air embolisms and blockages, blood incompatibility, catheter-associated urinary tract infections, pressure ulcers, vascular catheter-associated infections, chest infections after coronary bypass graft surgeries and hospital-acquired injuries like fractures.

Cigna is the latest in a line of insurers that have said they will no longer pay for the care of patients who experience medical mistakes while under providers' care.

 

Recently, Wellpoint Inc. announced that its 14 state Blue Cross Blue Shield plans would not reimburse hospitals for serious, preventable medical errors.

Earlier in the year, Aetna Inc. announced it was adopting a policy of not paying for medical mistakes.

From the payer side, a handful of state hospital associations have announced that their members would not bill payers for providing care to rectify mistakes that occur in the course of an inpatient stay.

Cigna justified its decision to not reimburse for never events by saying they are not medically necessary and said that it would stop paying for the errors "when permitted under its hospital contracts," a press statement said.

"Cigna's policy is designed to avoid member liability for any payment denials to participating facilities," the statement continued.

"Cigna is committed to improving quality for our members throughout the healthcare system," said Jeff Kang, MD, chief medical officer for Cigna HealthCare. "Our policy on never events and avoidable hospital conditions is designed to put patient safety first and to encourage hospitals to improve quality every day, one patient at a time."