OASIS Alert

The Centers for Medicare & Medicaid Services has issued the draft data specifications to go along with its proposed OASIS revisions, but theyre not mandatory.

The data specs, version 1.30, wont go into effect until Dec. 16, but should help software developers prepare applications in plenty of time for the change.

CMS has designed the specs to be "upwardly compatible," so that HHAs have the option of sticking with their old software if they want to. "If an agency wishes to begin using the reduced-burden data set on December 16, it may do so," CMS notes.

"But if it wishes to continue using the full OASIS data set and the current version of its data submission software on or after that date, it will have that option," the agency adds.

The only exception is that the state system will reject any record with RFA 02 or 10, since CMS will eliminate the requirement for those assessment time points.

The new "streamlined" national coverage process took an average of 383 days to process decisions in fiscal year 2001, CMS told Congress in its first annual report on the topic.

CMS insists it met the deadlines it set itself to process coverage determinations quickly. It responded to "straightforward" coverage requests within 90 days and put more complex requests through a technology assessment or Medicare Coverage Advisory Committee review within 180 days for each, CMS insists.

The CMS report is at http://cms.hhs.gov/coverage/.

Effective immediately, CMS will assign ID numbers to every branch of a parent home health agency. Agencies will then submit their branch ID number on OASIS assessments, which will allow CMS to develop "outcome reports that will help HHAs differentiate and monitor the quality of care covered by their agencies down to the HHA branch level," according to a recent memo.

Regional offices must ensure that all HHA branches have been assigned an ID number by the end of 2003, CMS says. Agencies then will be required to enter their number on M0016.

Medicare interest rates on over- and underpayments increased to 12.625 percent on Aug. 8, CMS says in Aug. 9 program memorandum AB-02-118. This rate is up from the previous rate of 11.75 percent.

CMS slowly but surely is converting demonstration providers in the Program of All-Inclusive Care for the Elderly to permanent PACE providers. CMS and the Washington State Department of Social and Health Services have approved a request by Providence Elder Place-Seattle to become the third permanent PACE provider.

The PACE program furnishes comprehensive care that allows frail elderly people to live in their communities rather than be institutionalized, CMS notes. "PACE is available only in states that have chosen to offer the program under Medicaid," CMS explains.

PACE, which began as a demonstration project, currently has 25 sites in 15 states, CMS says. PACE has been a permanent part of the Medicare program since November 1999 and enables demo sites to convert to permanent status.

Information on the PACE program is at www.cms.hhs.gov/pace/.

New projections of vastly increased budget deficits have wiped out all but the industrys faintest hopes for elimination of the 15 percent cut to home care reimbursement slated for Oct. 1.

The Congressional Budget Office is projecting deficits of $157 billion for this year, $145 billion for fiscal year 2003 and $111 billion for 2004. These deficit predictions are in spite of the fact that CBO forecasts that Medicare spending wont be as high over the next 10 years as it formerly calculated. While the budget projections look dire, Congress has expressed ample support for eliminating the home care reimbursement reduction, lobbyists note.

Washington Gov. Gary Locke (D) says he supported the 25 cent-per-hour raise for home care workers passed by the state legislature, but the states budget deficit wouldnt allow him to approve it, reports the Associated Press. Locke said home care workers deserve a raise and the issue will come before the legislature again.

Still, Locke received hisses from the delegates of the Washington State Labor Councils convention in Spokane when explaining why he shot down the raise, reports the Spokane Spokesman-Review. About 26,000 home care workers recently joined the Service Employees International Union Local 6.