By Molly Knobler & Talia Mermin of Phillips & Cohen, LLP
Today, we are turning back to healthcare because the World Health Organization has declared September 17th Patient Safety Day. Established in 2019, Patient Safety Day was created to raise awareness of the need to make patient safety a global health priority and to bring stakeholders together in an effort to reduce the incidence and severity of unintended harm caused by healthcare.
Medical errors are the eighth leading cause of death in the United States. More people die from medical errors than from motor vehicle accidents, breast cancer, or AIDS. The estimated annual cost of additional medical and short-term disability expenses associated with medical errors is $19.5 billion.
Government-imposed penalties are increasingly being used to incentivize and enforce patient safety. For example, the Hospital Acquired Condition Program is a Medicare value-based program that reduces payments to hospitals based on their performance on measures related to hospital-acquired conditions.
Similarly, the Hospital Readmissions Reduction Program seeks to reduce readmissions for certain specified conditions. Between fiscal year 2012 and fiscal year 2017, hospitals experienced nearly $1.9 billion in penalties related to “excess” readmissions.
Whistleblowers often spur investigations of conduct that “threaten[s] both the health of patients and the financial integrity of the Medicare and Medicaid programs[.]” The Department of Justice has long viewed the False Claims Act as a tool to enforce patient safety, recover taxpayer money, and deter future patient harm.
For example, whistleblowers have been essential in uncovering and prosecuting cases involving adulterated pharmaceuticals, unsafe pharmaceutical promotional practices, and physicians who perform medically unnecessary procedures, including invasive cardiac procedures, radical hysterectomies, or unnecessary administration of chemotherapy.