Payment for Health Care-Acquired Conditions and Provider-Preventable Conditions Sample Clauses

Payment for Health Care-Acquired Conditions and Provider-Preventable Conditions. The Contractor shall develop policies and procedures to prohibit the payment of charges for certain hospital acquired conditions and “never events.” These policies and procedures shall be approved by OMPP prior to implementation and upon any subsequent change.
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Payment for Health Care-Acquired Conditions and Provider-Preventable Conditions. The Contractor shall develop policies and procedures to prohibit the payment of charges for certain hospital acquired conditions and “never events.” These policies and procedures shall be approved by OMPP prior to implementation and upon any subsequent change. In accordance with 42 CFR 434.6(a)(12), 42 CFR 438.3(g) and 42 CFR 447.26, no payment shall be made by the Contractor to a provider for a provider-preventable condition as identified in the State Plan. All payments made by Contractor for “never events” shall be recovered by the Contractor and/or OMPP as prescribed in section 7.4 Program Integrity Overpayment Recovery.
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Payment for Health Care-Acquired Conditions and Provider-Preventable Conditions. The Contractor shall develop policies and procedures to prohibit the payment of charges for be approved by OMPP prior to implementation and upon any subsequent change. In accordance with 42 CFR 434.6(a)(12), 42 CFR 438.3(g) and 42 CFR 447.26, no payment shall be made by the Contractor to a provider for a provider-preventable condition as recovered by the Contractor and/or OMPP as prescribed in section 7.4 Program Integrity Overpayment Recovery. licies on non-payment of certain hospital-acquired conditions must comply with 405 IAC 1-10.5-5 and the IHCP Provider Bulletin regarding Present on Admission Indicator for Hospital Acquired Conditions dated August 25, 2009 (BT200928), as well as any updates or amendments thereto. In accordance with 42 CFR 447.26(d), the Contractor shall require that as a condition of payment, all providers agree to comply with the reporting requirements in 42 CFR 447.26(d). -payment of certain never events shall be developed in accordance with current Medicare National Coverage Determinations (NCDs), as well as any Indiana Medicaid FFS rules or other guidance adopted or issued by OMPP at a future date.
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