Home Health & Hospice Week

Tip: Every qualifying OASIS counts now.

As of July 1, your OASIS submission statistics will determine whether you get paid the full Medicare payment amount.

Reminder: In the 2015 home health prospective payment system final rule, the Centers for Medicare & Medicaid Services finalized a requirement for home health agencies to hit a 70 percent benchmark for OASIS submission (see Eli’s HCW, Vol. XXIII, No. 39). HHAs must successfully submit an OASIS record for 70 percent of those episodes qualifying as a “quality episode of care,” according to the rule published in the Nov. 6, 2014 Federal Register.

Agencies that fail to meet the “Quality Assessment Only” standard in the July 2015-to-June 2016 time period will face a 2 percent pay reduction in 2017.

You can get an idea of how you will fare by looking at a new report CMS has issued to HHAs, which tells you your OASIS stats for the July 2013-to-June 2014 period. “These reports are purely informational and will have no impact on providers’ payments,” CMS notes in a release. “They will be available in the CASPER folders for 120 days, or until October 26, 2015.”

Coming up: When looking at the stats in your QAO report, keep in mind the 80 percent benchmark CMS has proposed for the year starting next July, and 90 percent proposal starting in  July 2017. Both are contained in the 2016 HH PPS rule issued July 6 (see Eli’s HCW, Vol. XXIV, No. 24). 

Note: The 2016 proposed rule is at www.gpo.gov/fdsys/pkg/FR-2015-07-10/pdf/2015-16790.pdf