Home Health & Hospice Week

Get used to the changes that you'll have to use as early as Dec. 27.

You have only a few short months to get your staff proficient with a revamped OASIS tool.

The Centers for Medicare & Medicaid Services has issued the finalized OASIS dataset, OASIS B-1 (1/2008), that takes into account the prospective payment system refinements that will hit Jan. 1. The new OASIS tool will add M0110 on early/late episodes to all assessments and add M0470, M0474, M0520 and M0800 to recertification and follow-up assessments and will drop M0175 and M0610, CMS notes on its Web site.

The new therapy item, M0826, will replace the current M0825. And the new diagnosis coding item, M0246, will replace the current M0245. (For more information on OASIS changes under the PPS revisions, see Eli's HCW, Vol. XVI, No. 30).

Pitfall: Home health agencies will begin using RFA 4 and 5s Dec. 27 and all assessments Jan. 1. Don't mess up and use the new OASIS form before it's allowed, experts caution.

HHAs must use the new version of OASIS (01/2008) effective Dec. 27 for all Recertification assessments completed during the five-day window for episodes that begin on or after Jan.1, the National Association for Home Care & Hospice explains to it members. "However, during this same time period, the current version of OASIS (12/2002) must continue to be used for all Start of Care, Recertification, and Significant Change in Condition assessments if the episode start date is in 2007," NAHC cautions.

The new dataset is at www.cms.hhs.gov/HomeHealthQualityInits/12_HHQIOASISDataSet.asp under the "Downloads" section, dated 2008/01.

• There's no deadline yet by which DMEPOS suppliers nationwide must be accredited, confirmed a CMS official in the agency's Oct. 10 home health Open Door Forum. Rumor had it that April 2009 was the "drop dead" date, said CMS' Sandra Bastinelli, speaking at the forum. "If someone was betting on it, [that date] wasn't even close," she said. "It wasn't even a proposed date."

CMS will post the date, when it's available, on its Web site, agency officials said, offering no news of just when that would be.

• Don't get too comfortable with your 2008 payment rates. The American Medical Association and AARP are buying television ads to put pressure on members of Congress to stop the 10 percent cut to physicians' Medicare payments. The pressure from the heavy-hitting lobbies may result in payment cuts for home care providers, observers predict.

But there's also a chance for gains in this congressional session. Sen. Susan Collins (R-ME) is introducing bipartisan legislation that will curb the payment cuts CMS seeks to impose for supposed case mix creep. CMS plans 10.96 percent in such cuts over the next four years. Sens. Bob Casey (D-PA), Kit Bond (R-MI) and Maria Cantwell (D-WA) are co-sponsoring the bill, Collins says in a release.

• If you've had trouble getting long-term care insurers to pay up, relief may be on the horizon. Influential Senate Finance Committee ranking member Charles Grassley (R-IA) has asked 11 LTC insurers to provide business practice information, according to press reports. Grassley is concerned because the National Association of Insurance Commissioners found a 92 percent increase in complaints about long-term care insurers between 2001 and 2006.

• The federal government is ponying up more money to keep seniors in their homes. The Nursing Home Diversion Modernization Grants Program awards $8.8 million to 12 states to help impoverished seniors without overwhelming health concerns remain in their own homes.

The federal government will provide states with approximately $5.7 million of the total sum, with state Medicaid programs contributing an additional $3 million. Illinois will spend more than any other state on the effort at $1.7 million, while Kentucky's grant totals a mere $470,376. Other states participating include Arkansas, Connecticut, Georgia, Maryland, Michigan, Minnesota, New Hampshire, New Jersey, Vermont and West Virginia.

• Don't expect to see a revamped PS&R system any time soon. "The nationally planned change over to the PS&R Redesign program has been further delayed," regional home health intermediary Palmetto GBA reports on its Web site.

CMS originally set a February 2007 deadline for implementation of the new system. "The new implementation date has not been determined," Palmetto says. "The current PS&R program has been updated to accommodate cost report filings and settlements until the PS&R Redesign schedule has been determined."

• Some billing clearinghouses are still stripping the National Provider Identifiers (NPIs) from claims, and some billing services aren't adding the NPIs even when providers ask them to, CMS warns. This could have a drastic effect on your cash flow, especially as contractors turn on Part B edits to validate NPI/legacy pairs against the NPI crosswalk.

• Chances are you're having to pay your therapists more. Payment rates for home health occupational therapists went up about 4 percent from 2006 to 2007, reports the Hospital & Healthcare Compensation Service in its latest HOMECARE Salary & Benefits Report. HHAs paid OTs a median hourly rate of $31.12 this year, Oakland, NJ-based HCS says.

Physical therapist pay rates went up even higher with a 6 percent increase to a $34.50 median hourly rate, according to the study of more than 1,400 agencies' data.

"Comparatively, hospital OTs earned $29.50 per hour, while hospital PTs earned $32.60 per hour," HCS notes in a release. Perhaps the higher pay in home health is one reason for another report finding ...quot; turnover rates for PTs and OTs decreased in 2007.

Information on ordering the report is at www.hhcsinc.com.