Industry Notes:
PPS REFINEMENTS BRING OASIS CHANGES
Published on Mon Aug 06, 2007
Get ready for 2 more quality measures.
If you're in doubt that OASIS will be more important than ever under the new prospective payment system refinements, just look at some of the coming PPS changes.
Quality measures: The PPS refinements final rule that the Centers for Medicare & Medicaid Services released Aug. 22 adds two new publicly reported quality measures in 2008. That's in addition to the 10 already reported on Home Health Compare, for a total of 12 measures, noted CMS' Randy Throndset in the Aug. 29 Open Door Forum for home care providers. These additional measures are "Emergent care for wound infections, deteriorating wound status" and "Improvement in status of surgical wounds."
Pressure ulcer staging: CMS clarifies that it has revised the instructions for OASIS item M0460 that requires staging pressure ulcers. Instructions now "allow a wound to be staged if the bed of the wound is partially covered by necrotic tissue and if the presence of eschar does not obscure the depth of the tissue loss," the final rule states (see Eli's HCW, Vol. XVI, No. 27).
OASIS form: The PPS rule doesn't finalize the actual changes to the OASIS form, Throndset explained in the forum. Those revisions, which must go through the Paperwork Reduction Act process, will be finalized and posted "very soon," he promised. Among the changes are the new therapy item (M0826) that asks for the specific number of therapy visits instead of whether the visits will exceed the therapy threshold. • Veterans who live in New Jersey may soon have an easier time receiving home care. In August, Gov. Jon Corzine (D) signed into law a bill that directs the state adjutant general to evaluate the costs and benefits of providing home care aides to veterans who are elderly or disabled.
The report, due to the state legislators within six months, must make specific recommendations on state funding that would be needed to meet the added demand for home care services. The report must also address how the program would work with Medicare, Medicaid and private health insurance.
"It's important that we explore and consider new options for our veterans who require prolonged medical care," Corzine said in a release. "These alternative programs have the potential to allow veterans to receive the care they need from the comfort of their home while at the same time reducing the long-term demands of the (state)." • National Provider Identifier problems won't be limited to Part A providers anymore. Between Sept. 3 and Oct. 29, all Durable Medical Equipment Medicare Administrative Carriers (DME MACs) and Part B carriers "will begin to turn on edits to validate the NPI/Legacy pairs submitted on claims," CMS explains in an email to providers. "If the pair [...]
