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Medicare penalties to hospitals for readmissions

Medical malpractice suits are often hard fought. However, the injuries patients may experience from hospital negligence are serious and sometimes fatal. It is for this reason that instances of medical malpractice must be reduced by both court deterrence and other efforts. One effort currently being made addresses issues of hospital readmissions.

It appears the U.S. government has stepped into the ring in an effort to keep instances of medical malpractice at a minimum by imposing penalties on hospitals for readmission rates. Beginning October 2, 2012, Medicare will reduce a hospital's Medicare reimbursement allowance if the hospital readmits patients. This is part of the Affordable Care Act effort to encourage hospitals to ensure patients obtain all required care during their first visit.

Almost one in five Medicare beneficiaries is readmitted every month. The hospitals will lose a percentage of Medicare reimbursement for each readmitted patient. The hospitals affected include some of the most well-respected hospitals in the nation.

Not surprisingly, hospitals are particularly displeased with this new rule. Many doctors say that they cannot control some reasons for readmission, for example, when a patient fails to take his or her prescription medication.

Of course, the fact that a patient is readmitted does not in itself mean malpractice has occurred. But the new regulations may have the effect of reducing instances of malpractice by forcing hospitals to pay more attention to successful outcomes on the first admission.

In Connecticut, an injured individual may be able to bring a medical malpractice suit against a hospital or a doctor. He or she must show that the provider owed a duty and breached that duty by committing a negligent act. Connecticut courts will consider a medical act negligent if it deviates from the standard of care a reasonable professional with a similar practice would have applied in a similar situation.

These allegations are sometimes difficult to prove when it comes down to the word of the patient against the doctor. For this reason the testimony of expert witnesses is critical in medical malpractice cases.

Ultimately, the last place a person should have to fear for their safety is in a hospital, where they've come to seek assistance to their health.

Source: BBC News for Michigan, "Thousands of hospitals face penalties for high readmission rates," Aug. 14, 2012.

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