Year's End Notables
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National Task Force Recommends OASIS Streamlines
In response to CMS’s invitation to submit recommendations on ways to reduce paperwork and streamline patient assessment requirements, a task force called the OASIS Provider Task Force has been established. It consists of representatives from national associations, home health agencies, and consumer advocates. The goal of this task force is to develop ways to consolidate the OASIS document and its related regulatory mandates. Many home health providers believe that the increased paperwork required by OASIS has negatively impacted their ability to recruit and retain nurses in an already understaffed environment. Because of the costs associated with implementing and maintaining OASIS regulatory compliance, many providers often cite OASIS as the number one reason nurses leave home healthcare. They also believe that the cost of OASIS exceeds payment, as they are not compensated for the cost of professional staff time or the technology necessary for OASIS data collection and submission and prospective payment systems implementation.
The task force has submitted a letter to CMS with their recommendation of items that could be eliminated from the OASIS data set and as well as other numerous changes to regulatory requirements. The OASIS Provider Task Force is awaiting response to its request for an opportunity to discuss its recommendations with CMS officials.
GAO Looks at Medical Supplies in Home Health
Currently, Medicare makes a single payment to HHAs for each 60-day episode of care. This payment covers most services and supplies (including nonroutine supplies but excluding durable medical equipment) without regard for volume or types of services and supplies actually provided during the episode. Additionally, HHAs are responsible for submitting all Part B claims for services or supplies, whether they have furnished them directly or under an arrangement with an outside supplier (called consolidated billing).
Nonroutine supplies include, but are not limited to: dressings and other wound care items, IV supplies, ostomy supplies, catheters, and catheter supplies. If certain supplies covered under PPS are too costly relative to the episodic payment, HHAs might be inclined to “pinch” on needed supplies, or even avoid admitting patients who, during preadmission, could be identified as needing them. On the other hand, excluding too many supplies could also undermine the cost control potential of PPS. The Government Accounting Office (GAO) has been asked to review the process used to include nonroutine medical supply costs in the PPS and provide recommendations as to whether certain supplies should be excluded from the per episode payment; thus, allowing them to be billed separately. - OWM