Under the changes to the IPPS rule, hospitals now will be required to submit a “present on admission” flag (“POA”) for secondary conditions that (a) could result in higher payments and (b) are reasonably preventable through the use of evidence-based guidelines. The addition of the POA indicator may be a red flag for malpractice claimants that a condition developed during a hospital stay and the denial of additional payment may provide some evidence that the secondary condition was reasonably preventable, had the hospital followed evidence-based care guidelines. Consequently, hospitals must develop processes to assure that POA information will be as complete and accurate as possible to avoid potential losses.