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California’s Largest Health Insurer Narrows Its Coverage Scope


Aired 4/19/09

California’s largest health insurer says it will no longer reimburse hospitals for additional care that stems from preventable medical errors. Anthem Blue Cross says it hopes the policy will force hospitals to cut down on mistakes. KPBS reporter Kenny Goldberg has the story.

The company says there are three events they will never pay hospitals for: surgery on the wrong body part, surgery on the wrong patient, and a surgical procedure a patient should never have received. There are eight other conditions the insurer won't pay for if the hospital is found at fault.

Dr. Zeinab Dabbah is the chief medical officer for Anthem Blue Cross . She says the new policy isn’t about saving money.

Dabbah : Because if the hospitals and the providers are doing the right thing, then these events should never take place. And as such, we're not going to save any money on it.

Medication errors are not covered under the new policy. Dabbah says her company is encouraging hospitals to use electronic prescribing to reduce such mistakes.

Kenny Goldberg, KPBS News.

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