Provider Preventable Conditions

Providers must adhere to the Pennsylvania Department of Public Welfare (DPW) “Provider Preventable Conditions” Bulletin issued in June 2012 and updated in September 2015. Provider Preventable Conditions include but are not limited to:

  1. The wrong operation/invasive procedure on correct patient.
  2. Operation/invasive procedure on patient not scheduled.
  3. The correct operation/invasive procedure on wrong side/body part.

Provider Preventable Conditions involving a Carelon member must be reported to Carelon using Carelon’s Reportable Event form, as well as reported to the Department of Public Welfare using the OPPC Self-Reporting Form.