Home Health & Hospice Week

CMS proposes OASIS submission benchmarks starting in 2015.

Getting the majority of your OASIS assessments in will no longer cut it if a provision in the new PPS proposed rule becomes final.

For the first time, the Centers for Medicare & Medicaid Services will require a “minimum submission threshold” for OASIS. CMS plans “to re-quire all HHAs to achieve a Pay-for-Reporting performance requirement compliance rate of 90 percent or more,” the agency says in the 2015 home health prospective payment system proposed rule issued July 1. In other words, HHAs must submit both ad-mission and discharge OASIS assessments for a minimum of 90 percent of all patients with episodes of care occurring during the reporting period, CMS explains in a fact sheet about the new rule.

“Only those OASIS assessments that contribute, or could contribute, to creating a quality episode of care are included in the computation” for the benchmark, CMS notes in the rule scheduled for publication in the July 7 Federal Register.

However, CMS will give agencies some time to come into compliance with the new requirement. The agency proposes that agencies must submit 70 percent of “Quality-Assessment-Only” assessments in 2015, 80 percent of QAO assessments in 2016, and then reach 90 percent in 2017.

The consequence: HHAs who do not meet the QAO metric benchmark will face a 2 percent reduction the following year, CMS says.

CMS’s QAO calculations are a bit fuzzy, but the benchmarks seem like they shouldn’t be too difficult for agencies to achieve, believes Chicago-based consultant Rebecca Friedman Zuber.