Physicians and hospitals are no longer paid for preventable serious adverse events under a law that went into effect in August 2009.
Act 1 of 2009 defines a preventable serious adverse event as one that:
- Is avoidable but occurs because of an error or other system failure
- Results in death, loss of body part, disfigurement, disability, or loss of bodily function for more than seven days
The list of events follows the National Quality Forum’s list, which includes:
- Surgery performed on the wrong body part or wrong patient
- Foreign object left in a patient after a procedure
- Infant discharged to the wrong person
- Death or serious disability from a medication error
- Death or serious disability from a fall while being cared for in a health care facility
The Department of Public Welfare has one year to finalize the list of serious adverse events. It must publish a proposed list in the Pennsylvania Bulletin. The public will have a chance to comment on the proposed list.
The law gives providers who inadvertently bill for a covered event 30 days after discovery of the event to refund payment. It also will not allow information related to compliance with the act to be admissible in medical liability cases.
The Pennsylvania Medical Society worked for a balanced law to be fair to both patients and physicians.