The home health industry is one step closer to V code implementation with new data OASIS specifications that will go into effect in October. The Centers for Medicare & Medicaid Services has released the draft specs for OASIS 1.40 to help software developers and others prepare for the change, it says. The specs specify that V and E diagnosis codes will not be allowed in M0190, M0210 or new item M0245, but will be allowed in M0230 and M0240 (see Eli's HCW, Vol. XII, No. 13, article, Diagnosis Coding). Home health agencies also must start using the standardized branch identification number issued by the state in M0016 for assessments completed Jan. 1, 2004 and later, CMS says. Interested parties can download the draft specs at
www.cms.hhs.gov/oasis/datasubm.asp. CMS plans to release the final version by Aug. 31. In other OASIS news, CMS has issued Microsoft Word files of the reduced OASIS dataset so HHAs can cut and paste if they modify their own assessment forms. "Use of a new reduced OASIS assessment form is completely optional" until Oct. 1 when M0245 is required, CMS reminds agencies. The files are at
www.cms.hhs.gov/oasis/oasisdat.asp. The government would like to see HHAs pushed out of Medicaid home care services for the disabled in many cases, but it might mean more business for home medical equipment suppliers. Disabled Medicaid beneficiaries are more satisfied when they participate in consumer-directed care, a program where they receive a home care allowance and have wide flexibility in how to spend it, reports the Department of Health and Human Services and the Robert Wood Johnson Foundation. Beneficiaries often hire friends or family members as their caregivers and can purchase assistive equipment or home modifications with the funds. Patients using the Cash and Counseling program "appeared to get better care than those receiving services through home care agencies," according to a study of a consumer-directed care demonstration program in Arkansas. The demo project also maintains beneficiaires' health and safety, HHS says. New rules for determining provider-based status will go into effect for grandfathered entities July 1, CMS notes in April 18 program memorandum A-03-030. Entities considered provider-based in October 2000 qualified for grandfathering. HHAs that missed the Home Health Quality Initiative Open Door Forum March 27 may want to brush up on the measure now that its implementation is imminent. CMS has posted a 44-page transcript of the call, which gives an overview of the project, at
www.cms.hhs.gov/quality/hhqi/OpenDoorTranscript.pdf. In the largest Medicaid fraud settlements in U.S. history, drug giants Bayer Corp. and GlaxoSmithKline have paid a total of $344 million for allegedly engaging in an illegal "lick and stick" scheme, U.S. Attorney Michael Sullivan reports. The Department of Justice [...]
