Health Care Acquired/Preventable Conditions. Provider agrees that no payment shall be made for the provision of medical assistance for health care acquired conditions and other provider preventable conditions as may be identified by the State. As a condition of payment, Provider shall identify and report to Subcontractor any provider preventable conditions in accordance with 42 CFR Part 438, including but not limited to 438.6(f)(2)(i).
Health Care Acquired/Preventable Conditions. Provider agrees that no payment shall be made for the provision of medical assistance for health care-acquired conditions and other provider-preventable conditions as may be identified by TennCare as a condition of payment. At a minimum, this shall mean non-payment of provider-preventable conditions as well as Provider identification and reporting to Subcontractor and Health Plan and TennCare any provider-preventable conditions in accordance with 42 CFR §§ 434.6(a)(12), 438.3(g) and 447.26.
Health Care Acquired/Preventable Conditions. Provider agrees that no payment shall be made for the provision of medical assistance for health care acquired conditions and other
Health Care Acquired/Preventable Conditions. United and Subcontractor acknowledge and agree that United is prohibited from making payments to Subcontractor for the provision of medical assistance for health care-acquired conditions and other provider-preventable conditions as may be identified by LDH.
Health Care Acquired/Preventable Conditions. Health Plan, Subcontractor, and Provider acknowledge and agree that Health Plan and/or Subcontractor is prohibited from making payments to Provider for the provision of medical assistance for health care-acquired conditions and other provider- preventable conditions as may be identified by the Department. (2702 of the Patient Protection and Affordable Care Act - Federal Register / Vol. 76, No. 108 / Monday, June 6, 2011; 42 CFR 438.6(h), 42 CFR 422.208 and 422.210) As a condition of payment, Provider shall identify and report to Health Plan and/or Subcontractor any provider preventable conditions in accordance with 42 CFR §§ 434.6(a)(12), 438, including but not limited to § 438.3(g), and § 447.26.
Health Care Acquired/Preventable Conditions. Subcontractor, Health Plan, and Provider acknowledge and agree that Subcontractor and Health Plan are prohibited from making payments to Provider for the provision of medical assistance for health care-acquired conditions and other provider-preventable conditions as may be identified by the HHSC.
Health Care Acquired/Preventable Conditions. No reduction in payment for a provider preventable condition (“PPC”) shall be imposed on Provider when the condition defined as a PPC for a particular Covered Person existed prior to the initiation of treatment for that Covered Person by Provider.
i) Is identified in the State Plan;
ii) Has been found by the Department, based upon a review of medical literature by qualified professionals, to be reasonably preventable through the application of procedures supported by evidence-based guidelines;
iii) Has a negative consequence for the beneficiary;
iv) Is auditable;
v) Includes, at a minimum, wrong surgical or other invasive procedure performed on a patient; surgical or other invasive procedure performed on the wrong body part; surgical or other invasive procedure performed on the wrong patient. Provider must report to United provider preventable conditions associated with claims for payment or member treatments for which payment would otherwise be made. Non-payment of provider-preventable conditions shall not prevent access to services for Covered Persons.
Health Care Acquired/Preventable Conditions. United and Provider acknowledge and agree that United is prohibited from making payments to Provider for the provision of medical assistance for health care-acquired conditions and other provider-preventable conditions as may be identified by the Department. (2702 of the Patient Protection and Affordable Care Act - Federal Register / Vol. 76, No. 108 / Monday, June 6, 2011; 42 CFR 438.6(h), 42 CFR 422.208 and 422.210) As a condition of payment, Provider shall identify and report to United any provider preventable conditions in accordance with 42 CFR §§ 434.6(a)(12), 438, including but not limited to § 438.3(g), and § 447.26.
Health Care Acquired/Preventable Conditions. United and Provider acknowledge and agree that United is prohibited from making payments to Provider for the provision of medical assistance for health care-acquired conditions and other provider-preventable conditions as may be identified by the HHSC.
Health Care Acquired/Preventable Conditions. Xxxxxxx and Provider acknowledge and agree that Carrier is prohibited from making payments to Provider for the provision of medical assistance for health care-acquired conditions and other provider-preventable conditions as may be identified by HCA. As a condition of payment, Provider shall identify and report to Carrier any provider preventable conditions in accordance with 42 CFR § 434.6(a)(12), 42 CFR §438, including but not limited to § 438.3, and § 447.26.
