OASIS Alert
HHAs Still Waiting for RHHI Fix For M0110 Problem
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Volunteers needed for next phase as post-acute demo begins. If you don't understand risk adjustment, May 14 is the date for you. CMS addressed HHA concerns in the April Home Health, Hospice and DME Open Door Forum. CMS has yet to set a date for resolving the episode sequencing problem discovered more than a month ago. Specifically, the Common Working File isn't recognizing 2007 episodes when determining episode sequence for M0110. As a result, the system is coding all episodes as early even when they really are later episodes. "CMS is working with our contractors to get this problem corrected, but I don't have a date for the correction ... at this time," CMS' Wil Gehne told the forum attendees. Waiting for money: CMS also has yet to set a date for running adjustments based on the PPS billing errors so far. The agency wants to wait until all the errors are resolved, and will run the adjustments correcting those errors all at once. Hopefully agencies will see more positive than negative adjustments and thus won't see cash flow disruption due to the corrections, Gehne said. The adjustments will run automatically, he added. "HHAs won't have to take any special action." Tune In To May 14 ODF For Risk Adjustment Info Three other topics addressed at the ODF: 1. OBQI risk adjustments. CMS and its outcome-based quality improvement standards contractor will risk adjust all 41 OBQI measures, reported Turkay. Currently, 30 of the measures are risk adjusted while 11 are not. The new risk adjustment will begin in June. Contractor reps will be on the May 14 Open Door Forum call to explain the process, Turkay said. 2. Post-acute demo. The demonstration project for post-acute care reform has kicked off in Boston, a CMS staffer noted. The demo will take place in nine other cities by the end of the year, and CMS is still recruiting HHA participants in those areas. Next up are Chicago, Rapid City, SD and Rochester, NY. 3. Feds Provide Manual Overview. You can now consult an online brochure that provides an overview of CMS' online manuals, including the claims processing and benefit integrity manuals. The two-page brochure is at http://www.cms.hhs.gov/MLNProducts/downloads/onlinebrochure.pdf.
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