Senate Bill (S.B.) 7, 82nd Texas Legislature, First Called Session,
2011, and S.B. 7, 83rd Texas Legislature, Regular Session, 2013, requires the
Texas Health and Human Services to implement a hospital reporting process and
reimbursement reductions to hospitals based on their performance in potentially
preventable readmissions (PPRs) and potentially preventable complications
(PPCs). For the Medicaid Program, actual rates of these potentially preventable
events (PPEs) are compared to their expected rates and a final reimbursement
adjustment is determined and applied to all claims paid by the Texas Health and
Human Services to each hospital. Calculation of the PPE rates are made using
Medicaid/CHIP fee-for-service claims and managed care encounters.
For additional information and resources regarding the hospital
quality-based potentially preventable readmissions and potentially preventable
complications program visit the
Texas Health and Human Services Potentially Preventable Events webpage.