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First-in-the-Nation Health Care Billing Policy Announced in Minnesota

Minnesota hospitals, health plans and state establish statewide billing

policy for care made necessary by an adverse health event

WASHINGTON, Sept. 18 /PRNewswire-USNewswire/ -- In a speech to the Center for Health Transformation today, Minnesota Governor Tim Pawlenty announced that Minnesota is the first state in the nation to establish a statewide billing policy for care made necessary by preventable medical errors, or so- called "adverse health events," such as wrong-site surgeries and serious medication errors.

Under the agreement, hospitals in Minnesota will not bill insurance companies and others for any of the 27 types of reported "adverse health events," ensuring that patients will not have to pay for care made necessary by an adverse event. The adverse health events are defined by the National Quality Forum. The Governor's Health Care Cabinet endorsed the plan created by the Minnesota Hospital Association and the Minnesota Council of Health Plans. The policy builds on Minnesota's history of leadership in this area.

"It seems obvious to us, but Minnesota is the first state in the nation to agree that patients, employers and insurers shouldn't pay for care made necessary by an adverse health event," Governor Pawlenty said. "I want to thank our hospitals and health plans for their leadership in addressing this issue. We hope more states will follow our lead."

"One adverse health event is too many," Minnesota Hospital Association President Bruce Rueben said. "Our highest priority is to eliminate preventable errors in health care delivery. Until that happens, patients can have confidence they will never have to pay for care made necessary by an adverse event."

This policy formalizes the current billing practice of Minnesota hospitals. "Health plans are partnering with providers to ensure this statewide policy is implemented for every patient, every time," said Julie Brunner, Executive Director of the Minnesota Council of Health Plans.

Minnesota has a history of leadership in this area. In 2003, Governor Pawlenty signed nation-leading legislation establishing the Adverse Health Events Reporting law, requiring Minnesota hospitals, surgical centers and behavioral health hospitals to publicly report any occurrence of 27 "adverse health events." These events include wrong-site surgeries, serious medication errors, and sponges or other objects left behind in a patient at the end of surgery, to name a few.

In 2006, Minnesota facilities reported adverse health events occurring 154 times out of more than 8 million patient visits. Minnesota hospitals have utilized this information to share best practices and improve health care quality.

Learning leads to improved safety

Minnesota hospitals individually recognized the need for a proactive billing policy, and HealthPartners, a Minnesota-based insurer, was at the forefront of the issue, enacting a 2005 payment policy for care provided to their enrollees. Over the last few years, Blue Cross Blue Shield worked closely with the hospital association to create the framework for this statewide policy.

The Adverse Health Events Reporting law is an effective tool that allows hospitals to learn from events and make proactive changes to improve health care safety. This year, the Minnesota Hospital Association launched two comprehensive campaigns to address pressure ulcers and patient falls. These campaigns were created from national and local best practices, including key findings from events reported by Minnesota hospitals over the last three years.

The Minnesota Hospital Association is a trade association representing Minnesota's hospitals and health systems.

Established in 1985, the Minnesota Council of Health Plans is a trade association of eight licensed nonprofit health plans. Council members have pioneered a style of health care that has improved quality and consumer satisfaction and expanded access to health care for all Minnesotans. The Council and its members are leaders in health care reform, practice guidelines development, quality reporting and data collection and analysis.

SOURCE Minnesota Council of Health Plans
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