OASIS Alert

Published on Sat Mar 10, 2007 PDF

In March 8 testimony before the House Committee on Ways and Means, HHS Inspector General, Daniel Levinson, reiterated his concern about the accuracy of payments to home health agencies. He said the HHS Office of Inspector General would "review the extent to which Medicare HHAs accurately coded information on the assessment form that is used to determine payment rates." The OIG will also determine whether HHA rehabilitation services are medically necessary and are provided by the appropriate staff, he said.

• The Centers for Medicare & Medicaid Services is looking at the revised 2007 descriptions of pressure ulcers the National Pressure Ulcer Advisory Panel released in February. Agencies are asking for guidance about how to use these descriptions along with CMS' other instructions, a caller explained in the March 14 Home Health Open Door Forum. The NPUAP revisions are "under review," a CMS official responded.

• You can still use the old version of CMS-1500 until June 1, rather than the original April 1 date, CMS says. Next month, Medicare contractors were supposed to accept only the revised version (08-05), which accommodates the National Provider Identification (NPI) number. But the Government Printing Office has been selling an incorrect version of the revised form. And using this erroneous form will delay your payments.

To find out if your CMS-1500 version 08-05 is in danger of bouncing back, look at the upper right-hand corner of the form. Properly formatted claim forms contain approximately a one-quarter inch gap between the tip of the red arrow above the vertically stacked word "CARRIER" and the top edge of the paper. If the tip of the red arrow is touching or nearly touching the top edge of the form, the form is incorrect, CMS explained.

For more information, go to www.cms.hhs.gov/ElectronicBillingEDITrans/16_1500.asp.

• The National Multiple Sclerosis Society released a new guidance publication to assist home care providers in caring for persons with MS. The brochure discusses clinical, emotional and social needs of individuals with MS. It also includes eight appendices that address topics such as medications, catheter care, the Braden scale for measuring pressure ulcers, intrathecal baciofen therapy and resources.

Obtain copies free by contacting your local National MS Society chapter or by calling 1-800 FIGHT-MS. For more information go to www.nationalmssociety.org/mycommunity/index.asp.