DHCS Withholds Nearly $1M From Calif. Hospitals Over Medical Errors

From July 2013 to August 2014, 145 hospitals reported medical errors to the California Department of Health Care Services, and the agency has withheld $912,935 in Medi-Cal payments to at least 85 of those hospitals, according to data provided to KPCC's "KPCC News."

Medi-Cal is California's Medicaid program.

Under the Affordable Care Act, hospitals are required to report "provider preventable conditions" to DHCS.

Such medical errors could include:

• Allowing air into an IV line, causing an embolism;
• Giving an incompatible blood transfusion to a patient; and
• Leaving an object inside of a patient during surgery.

DHCS withholds reimbursements for any care necessary to fix such mistakes, according to the data given to "KPCC News."

The DHCS data did not include information on the monetary penalties for each hospital or how many patients were involved in the mistakes. Meanwhile, agency officials noted that the amount of Medi-Cal withholdings likely will change as hospitals file appeals.

CHA Comments

California Hospital Association spokesperson Jan Emerson-Shea said, "We fully agree that if there are preventable conditions that occur, hospitals should not be paid for treating them."

However, Emerson-Shea noted that hospitals define medical errors differently because the ACA's reporting requirements lack clarity. As a result, she said it is difficult to draw conclusions from reports of medical errors (Florido, "KPCC News," KPCC, 10/24).