Potentially Preventable Readmission

July 28, 2017


The Illinois Department of Healthcare and Family Services (HFS) has published a public notice proposing changes to the potentially preventable readmission (PPR) policy implemented January 1, 2013 as required by Public Act 97-689.

Beginning with State Fiscal Year 2018 (July 2017 – June 2018) HFS will suspend the current PPR penalty program. Effective July 1, 2017, HFS will begin analyzing hospital readmissions for beneficiaries covered under both the Medicaid fee-for-service and managed care programs. HFS will monitor and analyze the data to determine what future readmissions quality programs may be appropriate.

The cost reconciliations for the previous fiscal years through Fiscal Year 2017 will still be completed and any penalties owed for those fiscal years will be due. HFS anticipates releasing the reconciliation for Fiscal Year 2016 in the near future.