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

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 DHHR policy in accordance with 42 CFR §438.6 and 42 CFR §447.26. The MCO will track PPC data and make it available to DHHR upon request. Other provider-preventable condition means a condition occurring in any health care setting that meets the following criteria:

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 DHHR policy in accordance with 42 CFR §438.6 and 42 CFR §447.26438.6. The MCO will track PPC data and make it available to DHHR upon request. Other provider-preventable condition means a condition occurring in any health care setting that meets the following criteria:.