Can Hospitals Be Ousted From The Medicare Fold?

If Medicare can prove that hospitals under their aegis are guilty of mishandling and misrepresenting cases, they could face penalties as well as corrective action and in the worst case scenario, be ousted from the Medicare program. The very recent case has brought this to the forefront.

Three hospitals are involved and while the names of the patients involved are secret, three patients who received organs from an HIV and hepatitis infected donor are now suffering from the diseases. In the normal course of events, this is really a far-fetched occurrence but in this case, the high-risk donor was checked and not found infected.

What was missing was a costlier test which detects the virus even during the ‘window’ period which normally is not shown up by standard tests. The need for the newer test being a part of testing especially in cases like these cannot be emphasized enough. What is sad is that the patients who got the organs do not seem to have been aware of the likelihood of any infection.

In the event that it can be proved that there was mismanagement in this case, the hospitals stand to lose a great deal by way of revenue. Medicare and Medicaid are the ones who oversee programs involving organ procurement in all their participating hospitals across the nation. It is the very first instance where HIV has been spread from donor to recipients. The agencies concerned hope to make sure that they have the checks in place to make sure this is not repeated again.