Home Health & Hospice Week
OASIS Denials, Surety Bonds Stressed In OIG Report
As budget negotiations start to kick into gear for 2017, the HHS Office of Inspector General is reminding law- and policy-makers of ways they can cut Medicare home care spending. The OIG furnishes a rundown of unimplemented recommendations in its newly released annual report.
Idea #1: Medicare could trim $25 million by completing “a process that would allow the claims processing system to interface with State survey agency systems to identify, on a prepayment basis, home health agency claims without accepted Outcome and Assessment Information Set (OASIS) data submissions,” the OIG notes.
Last June, the Centers for Medicare & Medicaid Services said in an MLN Matters article about HIPPS code matching between claims and OASIS records that it would “provide notice to HHAs as soon as possible after we determine the implementation date” for edits that would deny claims with no matching OASIS records (see Eli’s HCW, Vol. XXIV, No. 14). CMS has yet to announce a date.
The requirement to match OASIS records with claims was actually contained in a 2012 transmittal. CMS spent 2013 testing the matching process for inpatient rehab facilities (IRFs), then implementing it for IRFs in 2014. CMS began testing the matching process for HHAs in 2014.
Idea #2: The OIG also pushes its HHA surety bond recommendation again.
Idea #3: And the watchdog agency wants CMS to “promote minimum standards in background check procedures” for HHAs, it adds.
See the report at http://oig.hhs.gov/reportsand-publications/compendium/files/compendium2016.pdf.
Home Health & Hospice Week
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