OASIS News:
P4P Demo Set For October
Published on Fri Jul 27, 2007
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New OASIS Q&As available.
The July 18 Home Health, Hospice and Durable Medical Equipment Open Door Forum was long on questions, but short on answers.
P4P update: No one could answer a question from Judy Adams of LarsonAllen about what is happening on the home health pay for performance demonstration program. But a Centers for Medicare & Medicaid Services official later reported that the demonstration is currently in the approval process at the Office of Management and Budget. Exact dates depend on when CMS receives approval, but the project is on target to begin recruitment in October with program implementation to begin in January 2008, the official tells Eli.
OASIS software: CMS held an OASIS teleconference July 25 for software vendors interested in the expected OASIS data set for the proposed changes to the prospective payment system. The OASIS v.1.60 (Draft) data submission specifications are available at www.qtso.com, an official reported.
Fraud & abuse: Forum leaders allowed no questions about the July 17 announcement that CMS is initiating a new fraud and abuse demonstration project targeting home health agencies in the greater Los Angeles and Houston areas.
The crackdown focuses on "preventing deceptive providers from operating," and affects all Medicare-certified agencies in Harris County, TX and in Los Angeles, Orange, Riverside and San Bernardino counties in CA, a CMS spokesperson confirmed at the July 18 forum. CMS promises to make more information available at the Aug. 29 Open Door Forum.
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A set of 19 new CMS OASIS clarification questions and answers are now available in a July 10 letter from CMS to OCCB posted on the OASIS Certificate and Competency Board Web site at www.oasiscertificate.org. The letter clarifies when certain environmental modifications affect your OASIS anwers and gives guidance on completing assessments, surgical wounds, infusions, and dyspnea among other topics.
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A complete list of new and updated ICD-9 codes and descriptors is included in CMS Transmittal 1269 (CR 5643). For more in-formation on diagnosis coding, see Eli's Home Health ICD-9 Alert aw www.elihealthcare.com/spec_health_icd-9.htm or by calling 1-800-874-9180.
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Almost a quarter of claims for negative-pressure wound therapy pumps didn't meet Medicare coverage criteria, according to a new report from the HHS Office of Inspector General (OEI-02-05-00370). Medicare spent $21 million in 2004 on medically unnecessary wound therapy, the report claims.