HCFA outlines upcoming changes in OASIS
By MATTHEW HAY
HHBR Washington Correspondent
WASHINGTON The Health Care Financing Administration (HCFA; Baltimore) already has more than four million Outcome and Assessment Information Set (OASIS) records in its national repository, which account for about 1.8 million Medicare and Medicaid home health patients. In addition, roughly 95% of agencies required to report OASIS data are doing so. But a senior HCFA official recently reported that some changes in OASIS are in the works.
Next week, the official said, HCFA plans to tweak the state agency systems. "We intend to enforce the data specifications as they are written," the official reported. For home health agencies that are using the HAVEN software, the change will not be very noticeable. Agencies that are using vendor software to enter their OASIS may or may not be affected, depending on whether the data meets the HAVEN data specifications.
What that means, she said, is that on or about May 1, home health agencies that had been receiving warning messages may now have records rejected if their software is not meeting the data specifications.
For example, she noted, unlike HAVEN, some software allows agencies not to answer certain data items. "We have been letting those records come into the repository so we did not frustrate people right off the bat," she said. "That will stop because that does not meet the data specifications, which say that every data item must be answered."
According to the official, the other change that is coming down the pike is how the agency treats data for non-Medicare and non-Medicaid patients. She said HCFA’s systems to accept data for these patients are now ready to go. When OASIS was implemented last summer, it was not applied to non-Medicare and non-Medicaid patients receiving skilled services until a system could be developed to mask the identity of those patients. That last minute change followed an intense debate over patient privacy that prompted Congress to threaten intervention.
The official said HCFA will implement the new system for these patients through a Federal Register notice that will contain details for when it will become effective and how it will operate. She said the new system will involve upgrading to another version of HAVEN software that will automatically read the payer source and, if it is a non-Medicare or non-Medicaid patient, make the patient indecipherable. "You will know what they are, but we will not know what they are," she said.
According to the official, the new version of HAVEN will be released in the next few weeks. But she would not specify exactly when the agency will implement the new system. "It will not happen next week, and it will not happen next month, " she said. "It is in the clearance process, and once it hits the clearance process, it is anybody’s guess when it will come out the other end." She added that HCFA is encouraging agencies to load the new version because it will also include other upgrades.
The official also confirmed that HCFA will not apply OASIS to patients receiving personal care services only. She said the agency has extended that delay for at least two years.
Finally, she warned that the home health prospective payment system (PPS) will not be implemented without at least some additional minor changes in OASIS. "There will be some changes, and we don’t know exactly what they will look like," she said. "When we do, we will post a new draft."
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