Common use of Payments for Provider-Preventable Conditions Clause in Contracts

Payments for Provider-Preventable Conditions. Section 2702(a) of the Affordable Care Act prohibits Federal financial participation (FFP) payments to States for any amounts expended for providing medical assistance for Provider Preventable Conditions (PPCs), including health care-acquired conditions (HCACs) and other provider-preventable conditions (OPPCs). PPCs are hospital-acquired conditions not present on hospital admission, the wrong procedure performed on a patient, and procedures performed on a wrong patient or body part. The MCO may not make payments for PPCs as defined by the federal regulations and BMS policy in accordance with 42 CFR 438.6. The MCO will track PPC data and make it available to BMS upon request.

Payments for Provider-Preventable Conditions. Section 2702(a) of the Affordable Care Act (ACA) prohibits Federal financial participation (FFP) payments to States for any amounts expended for providing medical assistance for Provider Preventable Conditions (PPCs), including health care-acquired conditions (HCACs) and other provider-preventable conditions (OPPCs). PPCs are hospital-acquired conditions not present on hospital admission, the wrong procedure performed on a patient, and procedures performed on a wrong patient or body part. The MCO may not make payments for PPCs as defined by the federal regulations and BMS policy in accordance with 42 CFR 438.6. The MCO will track PPC data and make it available to BMS upon request.

Payments for Provider-Preventable Conditions. Section 2702(a) of the Affordable Care Act prohibits Federal financial participation (FFP) payments to States for any amounts expended for providing medical assistance for Provider Preventable Conditions (PPCs), including health care-acquired conditions (HCACs) and other provider-preventable conditions (OPPCs). PPCs are hospital-acquired conditions not present on hospital admission, ,the wrong procedure performed on a patient, and procedures performed on a wrong patient or body part. The MCO may not make payments for PPCs as defined by the federal regulations and BMS policy policy. Additionally, the MCO must comply with any reporting requirements mandated by CMS to document the occurrences of PPCs in accordance with 42 CFR 438.6. The MCO will track PPC data and make it available to BMS upon requestthe Medicaid program.

Payments for Provider-Preventable Conditions. Section 2702(a) of the Affordable Care Act prohibits Federal financial participation (FFP) payments to States for any amounts expended for providing medical assistance for Provider Preventable Conditions (PPCs), including health care-care- acquired conditions (HCACs) and other provider-preventable conditions (OPPCs). PPCs are hospital-acquired conditions not present on hospital admission, the wrong procedure performed on a patient, and procedures performed on a wrong patient or body part. The MCO may not make payments for PPCs as defined by the federal regulations and BMS policy in accordance with 42 CFR 438.6. The MCO will track PPC data and make it available to BMS upon request.