Questions persist over changes in OASIS
By MATTHEW HAY
HHBR Washington Correspondent
WASHINGTON The home care industry is hoping Congress will force the Health Care Financing Administration (HCFA; Baltimore) to make further changes in its Outcome and Assessment Information Set (OASIS). But while some members of the House Ways and Means health subcommittee members reportedly asked the agency to postpone OASIS by a full year, HCFA is not saying much at the moment.
"On the Republican side, I am hearing rumors that there might be a bill or a request that HCFA go back and certify that every question is necessary," a senior House Ways and Means health subcommittee aide told HHBR. "There is certainly a lot of agitation out there about OASIS." But the aide said that Subcommittee Chairman Rep. Bill Thomas (R-CA) and ranking member Rep. Pete Stark (D-CA) are not currently working together on any specific request. "That doesn’t mean that a junior member might not easily get 10 or 15 signatures on something that would delay it for a year or delay it until HCFA really needs the data for a [prospective payment system]," the aide added. "You name it, there are any number of scenarios out there."
In the meantime, home care representatives are pressing HCFA for clarification on whether or not they will require data for both Medicare and non-Medicare patients. "There is still a lot of speculation that HCFA will not require agencies to report data for non-Medicare patients once HCFA starts accepting OASIS data," said one industry representative who has been consulting with HCFA on this issue on a regular basis. But at the moment, the agency appears uncertain about the course it will ultimately chart.
Earlier this month, a senior HCFA official told HHBR that the agency does not plan to receive non-Medicare information until it is capable of encrypting it, but that change has not been formally released by the agency. Days later, HCFA was prompted by a growing concern over patient privacy to delay the transmission of all OASIS data beyond the April 26 date specified in its regulation.
Before the agency can accept OASIS data, it must establish "a system of records" that define the "routine uses" for this data. No new transmission date was specified, but the new system must be published in the Federal Register at least 30 days before HCFA can require agencies to start doing so.
In a directive earlier this month, HCFA also instructed state and regional offices "not to cite noncompliance with OASIS requirements at this time." The agency added that "during this period of early implementation, it is important that surveyors recognize HHAs’ current ability to comply with the OASIS regulations and provide education where needed." Unfortunately, HCFA has yet to offer any instruction to agencies about encoding OASIS data in the interim and that has left agencies in a confusing position.
If agencies continue encoding OASIS data on all patients and HCFA does decide to exclude non-Medicare patient information, agencies will be forced to open each record and remove all non-Medicare data before transmitting, explained one industry representative.
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