Home Health & Hospice Week

CMS is working on hospice claims processing problems, official promises in Open Door Forum.

If you're working on an old computer, it may be time to make some upgrades.

To accommodate the upcoming Quality Improvement and Evaluation System (QIES) in January 2006, the Centers for Medicare & Medicaid Services is transitioning to a new computer system and reporting software, a CMS official reminded listeners in the Dec. 15 Open Door Forum for home health.

To access outcome-based quality improvement (OBQI) and error reports on the upgraded system, home health agencies have to meet new minimum system requirements by Dec. 31. CMS first told agencies about the change in a March 10, 2005 memo to surveyors (S&C 05-22).

A CMS survey of nursing homes at the time found about one-third of the facilities use computers that need upgrades to support the new software. Although CMS didn't survey HHAs, the agency said most systems at HHAs are likely due for an overhaul as well (see Eli's HCW, Vol. XIV, No. 12).

CMS will roll out the update in late January, the official told the forum, which drew 240 callers. While the change will affect OBQI reports, it won't affect OASIS, she added.

The new specifications require HHAs' PCs to have, at a minimum, a Pentium 3 CPU with 500 MHz; 256 Mb of memory; a Windows 2000 or XP operating system; 500 Mb of free space on the hard drive; and Internet browser Internet Explorer v5.5 SP2. More details are at www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter05-22.pdf. M0175 Recoupments Still Up In The Air HHAs can hang onto their M0175-related overpayments at least a little while longer, a CMS staffer said in the forum. CMS has delayed the M0175 recoupments to look at the legal issues raised by the National Association for Home Care & Hospice (see Eli's HCW, Vol. XIV, No. 42).

CMS has not set a timetable for resuming the recoupments, nor does it have any revised appeals procedures to offer, the official noted.

CMS is also working to get some "far-reaching" hospice claims system problems cleared up as soon as possible, the staffer promised in the forum. The system glitches are unrelated to the adoption of Core-Based Statistical Areas (CBSAs) for the wage index, even though they started at the same time.