OASIS Alert

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Home Health Compare Site Takes Hits

Published on Tue Aug 05, 2003

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With only a few months before the national rollout, what you see is what you get for your contact information.

The Centers for Medicare & Medicaid Services' pilot site providing public access to home health quality information is recording 500 to 800 hits per day. The site recently saw 5,000 visitors in one week, CMS said in the July 2 Home Health Open Door Forum.

The site (www.medicare.gov/HHCompare/Home.asp) also contains contact information for all home health agencies, in preparation for the expansion of the program to include all states beginning this fall. Agencies that didn't correct their contact information by Aug. 1 will not see their new information included until after the rollout, because of the long development cycle, CMS told forum participants. CMS plans to give an overview of the national project and related issues in an October satellite broadcast, the official said.

CMS also announced it was refining the site's search engine to allow a search by zip code, and said a Spanish language version is planned for launch next February. Currently, the site's main page directs Spanish-speaking users to obtain the information by calling 1-800-MEDICARE.

The HHS Office of Inspector General issued a new audit report attacking overpayments resulting from incorrect answers to M0175, and pinned part of the blame on home health agencies. "HHAs incorrectly billed services due to their clinicians not adequately completing the patient assessment instrument," the report says.

In "Review of Payments Made by Associated Hospital Services for Home Health Services Preceded by a Hospital Discharge" (A-01-03-00500), the OIG estimates regional home health intermediary AHS paid about $1.9 million in overpayments in 2001 for cases when the beneficiary was discharged from a hospital within 14 days prior to receiving home care. Under Medicare rules, payments should be lower for episodes directly preceded by a hospital discharge than they are for non-post-hospital care.

Warning: AHS plans to review 2001 claims and recover overpayments. And the AHS review is just the beginning - the OIG is examining post-hospital home care at RHHIs nationwide.

Lesson Learned: Focus on M0175 accuracy or face possible overpayment demands.

HHAs should be preparing to use a new OASIS version, CMS reminds agencies. "We expect version 1.40 of the data specifications to be implemented on October 1, 2003," CMS says in a note added to its OASIS Web site. "All assessments with completion dates (M0090) on or after 10/01/2003 must conform to the version 1.40 specifications." Assessments completed before that date should conform to 1.30 specs.

Version 1.40 includes a new OASIS item, M0245, as a result of V and E codes being required after Oct. 1 (see related stories "V Is For Coding Victory ... If You Mind Your Ps And Qs," "Visualize Coding Before And After October," and "Optimize Reimbursement With Correct Coding Choices").

Home health agencies will see a 3.3-percent increase in payment rates under the prospective payment system for episodes in 2004, CMS announced June 27. The rates were published in the July 2 Federal Register. Payment rates for HHAs are updated annually based on the percentage change in the home health market basket index, a measure of inflation for goods and services connected with home health services.

The new per episode amount prior to case-mix adjustment and wage index adjustment is $2,230.65. The new low utilization payment adjustment per visit rate prior to wage index adjustment is $44.09 for home health aides, $97.38 for skilled nursing, $156.10 for MSWs, $107.19 for OTs, $106.47 for PTs and $115.70 for STs.

Software vendors and HHAs that write their own OASIS software can call into an Aug. 20 teleconference put on by CMS. It aims to help vendors and agencies better understand the requirements and specifications for the new version of OASIS that takes effect in October. The technical teleconference, which will go over OASIS version 1.40, will be from 1 p.m. to 2:30 p.m. ET. More information is at www.cms.hhs.gov/oasis/82003svt.pdf.

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