471 NAC 46-004. NON-PAYMENT FOR HOSPITAL ACQUIRED CONDITIONS (HAC)

004. NON-PAYMENT FOR HOSPITAL ACQUIRED CONDITIONS (HAC). Nebraska Medicaid will not make payment for conditions which are a result of avoidable inpatient hospital complications and medical errors that are identifiable, preventable, and serious in their consequences to beneficiaries. This means that Nebraska Medicaid will, at a minimum, identify as hospital acquired conditions (HAC), those diagnoses codes that have been identified as hospital acquired conditions (HAC) by the Centers for Medicare & Medicaid Services (CMS) when not present on hospital admission. Any diagnosis code(s) which are flagged as hospital acquired conditions (HAC) will be excluded from the final claim All-Patient Refined Diagnosis-Related Group grouper (APR DRG) determination.