HCFA says announcement on the OASIS data is imminent
By MATTHEW HAY
HHBR Washington Correspondent
WASHINGTON The Health Care Financing Administration (HCFA; Baltimore) continued to send mixed signals last week over whether or not home health agencies are currently required to collect and encode Outcome and Assessment Information Set (OASIS) data for Medicare and/or non-Medicare patients. But late in the day on Friday, a senior HCFA official signaled that HCFA will not enforce OASIS collection requirements until it meets further regulatory requirements.
When asked by HHBR whether home health agencies should or should not collect OASIS data, the official from HCFA’s Center for Medicaid and State Operations had this to say: "We are working on something on that right now that should be posted in our Web site in the next day or two." Then, the official added: "Look at the last paragraph of our statements about enforcement."
The paragraph the official was referring to instructs state and regional offices "not to cite noncompliance with OASIS requirements at this time." HCFA had added that paragraph to its April 7 statement (which announced the delay in the April 26 date for transmission of OASIS data) before sending it to state and regional offices earlier this month.
That statement appeared to be tacit recognition on the part of HCFA that it can not enforce OASIS requirements until it publishes a system of records regulation as required by the Privacy Act and obtains clearance from the Office of Management and Budget (OMB) as required under the Paperwork Reduction Act.
One home care publication spent much of the week last week attempting to discredit reports by the National Association for Home Care (NAHC; Washington) that HCFA had suspended all OASIS requirements. "All regulations requiring OASIS data collection, encoding, and transmission are suspended for all patients until the system of records regulation is published," NAHC stated April 20.
The following day, the home care publication announced that NAHC’s report was "inaccurate" and based on "rumors." As evidence, it cited an un-named "senior HCFA official" as well as several OASIS coordinators. But by week’s end, it appeared that NAHC’s statement had been borne out by the trickle of information coming from HCFA.
In a statement on Friday, NAHC conceded that HCFA did not explicitly state that agencies are not required to comply with the OASIS requirements but said the agencies’ written communications "support this conclusion."
Several home care executives contacted by HHBR agree and say the attack on NAHC’s position misses the mark in several important respects.
First, NAHC’s statement coincided with a subtle revision HCFA made to its April 7 statement. On April 7, HCFA said that despite the delay in transmitting data that home health agencies would still be expected to conduct comprehensive assessments, including OASIS data, as currently required under the new conditions of participation (emphasis added). But on April 21, HCFA modified that to read, "Home health agencies are expected to conduct comprehensive assessments, and are encouraged to use the OASIS data set (emphasis added).
Second, NAHC’s April 20 statement goes on to encourage agencies to continue to collect OASIS data if they have already incorporated the OASIS data elements into their comprehensive assessment forms. The association reiterated this point on April 23 when it urged agencies to continue to collect OASIS data items and use this period to increase their proficiency.
These sources point out that in addition to its concern about compliance, NAHC was wrestling with how to advise its members from an operational standpoint. For example, if HCFA decides to eliminate the requirement that agencies collect and/or transmit OASIS data for non-Medicare patients, agencies that had collected these data would be forced to open each record and remove it.
Finally, veteran HCFA-watchers say the attack on NAHC’s position ignores strong indications that HCFA is slowly backing off enforcement of its OASIS requirements. "HCFA typically make these announcements in the 11th hour," said one industry executive. "The 11th hour in this case would be April 26 so I am not surprised to hear that HCFA says it is about to make another announcement."
"This is a very fluid environment and HCFA’s press office has not always been in synch’ with its policy arm," said another industry executive. "But it sounds to me like HCFA is moving in the direction NAHC indicated. I suspect we will know who was right soon enough."
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