OASIS Alert

Published on Fri Aug 30, 2013 PDF

Try this new ADR tool.

Would you like to give CMS an earful about your Medicare contractor? Sign up for a chance to express your level of satisfaction with your Medicare Administrative Contractor at http://cms.gov/Medicare/MedicareContracting/MSI. The Centers for Medicare & Medicaid Services will select a random sample of providers to fill out the Medicare Contractor Satisfaction Indicator (MSI) tool.

The MSI aims to measure the level of satisfaction providers and suppliers experience with their MACs, CMS says. “The MSI allows providers the opportunity to influence CMS’ understanding of Medicare contractor performance. The goal of the MSI is to evaluate these experiences and determine the key drivers of customer satisfaction.”

Plus: CMS will use the results of the MSI to monitor trends, improve oversight and increase the efficiency of the Medicare program, the agency says.

Respond To ADRs With Success

If you’re feeling bombarded by Additional Development Requests, a tool from HHH MAC CGS could help you respond successfully to the ADRs.

Tip: “Have a plan to handle the requests, including a person who can review the documentation before sending to ensure it’s complete,” CGS says in the tool at www.cgsmedicare.com/hhh/education/materials/pdf/Success_MR_Requests.pdf.

You should realize that the deadline for returning medical records varies depending on who is requesting them, CGS adds. You have 30 days to respond to an ADR from your MAC, but 75 days when the Comprehensive Error Rate Testing (CERT) contractor requests records, for example.

Learn About Your Discharge Requirements

Looking for a quick recap of what Medicare expects of you regarding discharge? Check out a new Medicare Learning Network booklet on discharge requirements for home health agencies, hospices, and other post acute care providers at www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Discharge-Planning-Booklet-ICN908184.pdf.

“A physician’s order is not required to discharge the patient unless the HHA has such a policy or it is required by State law,” the booklet explains in its home health section.

Get Help with Therapy Hold Reassessment Questions

If therapy holds are tripping up your reassessment window for the discipline, an educational tool from one HHH MAC may help. NHIC addresses the issue of therapy that is on hold during the 30-day reassessment deadline. If home health agencies know the hold is going to occur — for instance, while the patient undergoes and recovers from a planned surgery — then the therapist should conduct the reassessment on the last visit before the hold takes effect.

If the hold is unexpected, however — say for an unplanned hospitalization during the 30-day deadline — then the therapist can complete the reassessment when the therapy resumes after the hospitalization, NHIC says.

More scenarios are addressed in the tool at www.medicarenhic.com/providers/articles/TherapyReassessmentArticle.pdf. 

Sign Up for Fall Prevention Study

Do you have a great strategy for preventing falls in older patients? Then the NIH may pay you to test it out with millions of dollars in funding.

The National Institutes of Health’s National Institute on Aging is soliciting proposals for a clinical trial that will prevent serious injuries resulting from falls in older people, it says in a release. Proposals should address an individual’s risk of falling, his or her physical and cognitive condition, the surrounding environment, and the ability to reduce risks, the NIA says.

The NIA is looking for the project to generate practices “that can be broadly applied by clinicians and accepted by older adults,” it says in a release.

Partnering with the NIA, the Patient Centered Outcomes Research Institute will commit up to $30 million to the project, NIA says. Proposals are due Nov. 13. More information is at http://grants.nih.gov/grants/guide/rfa-files/RFAAG-14-009.html.

HHQI Focuses On The Heart.

You have new free tools at your disposal to help improve patient outcomes in relation to cardiovascular health. The Home Health Quality Improvement (HHQI) campaign, conducted by CMS contractors WVMI and Quality Insights, has released its first Best Practice Intervention Package (BPIP) addressing cardiovascular health. “Cardiovascular Health Part 1: Aspirin as appropriate & Blood pressure control” is available at www.homehealthquality.org/Cardiovascular-Health/Best-Practices.aspx.

Next up: The HHQI campaign will release “Cardiovascular Health Part 2: Cholesterol management & Smoking cessation,” in November, it says on its website. The BPIPs support the Department of Health and Human Services’ Million Hearts^® initiative to fight heart disease and stroke.