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WellPoint to stop paying for some medical errors

April 2, 2008
WellPoint Inc. will no longer reimburse hospitals for serious preventable errors, the Indianapolis-based health insurer announced today. WellPoint's first phase of the initiative includes 11 preventable adverse events and will be modified and expanded in the future.

WellPoint said no one should be charged for the three most serious errors: performing the wrong kind of surgery on a patient, performing surgery on the wrong body part or performing surgery on the wrong patient.

For eight other events, WellPoint said it would pay nothing extra to cover procedures meant to fix earlier errors. Those events include leaving an object in the body during surgery, giving a patient incompatible blood, severe bedsores and injuries acquired in the hospital.

WellPoint officials said the initiative is designed to improve patient safety and protect WellPoint customers from extra charges.

"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 Dr. Sam Nussbaum, WellPoint's chief medical officer.

In a statement, WellPoint officials said they recently told hospitals about the new policy, which is intended to ensure that neither WellPoint nor its customers will be charged for serious errors.

It wasn't immediately clear whether all hospitals will agree to that policy.
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