Provider Preventable Conditions

PUBLIC NOTICE: 
SOUTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES

 

The South Carolina Department of Health and Human Services (SCDHHS) gives notice of the following proposed actions regarding Provider Preventable Conditions (PPCs) to include Hospital Acquired Conditions (HACs), Never Events (NEs), and Other Provider Preventable Conditions (OPPCs) under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Effective on or after July 1, 2014, SCDHHS proposes to amend the South Carolina Title XIX State Plan to add the following eight Other Provider Preventable Conditions (OPPCs) to the non-payment policy for provider preventable conditions (PPCs) in the current State Plan:

  • Post-operative death in normal healthy patient
  • Death/disability associated with use of contaminated drugs, devices or biologics
  • Death/disability associated with use of device other than intended
  • Death/disability associated to medication error
  • Maternal death/disability with low-risk delivery
  • Death/disability associated with hypoglycemia
  • Death/disability associated with hyperbilirubinemia in neonates
  • Death/disability due to wrong oxygen or gas

SCDHHS proposes to make this change to better align the plan with the desired health outcomes of the Medicaid population. The OPPCs being added are more specific to the Medicaid population, which will ultimately improve the quality of care for these individuals in South Carolina.

SCDHHS projects that upon implementation of the proposed action noted above, Medicaid fee for service rates will not be impacted as this change results in an addition of OPPCs to the current list, but not a change in the payment rates to providers.

Copies of this notice are available at each County Department of Health and Human Services Office and at www.scdhhs.gov for public review. Additional information regarding this proposed action is available upon request at the address cited below.

Written comments may be sent to the Office of Health Services, SCDHHS, Post Office Box 8206, Columbia, South Carolina 29202-8206. Comments may also be submitted to comments@scdhhs.gov. Written and e-mailed comments must be received by close of business May 29, 2014.

Any written comments submitted may be reviewed by the public at the SCDHHS, Office of Health Services Jefferson Square Building, 1801 Main Street, Columbia, South Carolina, Monday through Friday between the hours of 9:00 A.M. and 5:00 P.M.

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