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 Potentially Preventable Events (PPE)

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.

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