Regulations: Medicare Will Keep The OASIS Guidance Coming

Plus: Rural add-on, QRP education, more.

Perhaps due in part to the appearance of OASIS-D on the horizon, the Centers for Medicare & Medicaid Services plans to resume its quarterly issuance of questions and answers for OASIS.

So said a CMS official in the May 15 Home Health Open Door Forum. CMS will post a new Q&A set quarterly in January, April, July, and October, the CMS staffer explained. The questions come mainly from the QTSO help desk, which providers can contact at

CMS recently issued its first OASIS Q&A guidance in two years, addressing a variety of topics from M1060 to Resumption of Care date changes, the CMS source said. See the Q&As at Qtr_2018_QAs_April_2018_FINAL_508.pdf. Other HHA topics addressed in the forum:

  • Rural add-on areas. The Bipartisan Budget Act of 2018 brought back the 3 percent rural add-on for home health agencies, although it phases the bonus payments out over five years.

Reminder: BBA 18 reduces the add-on to 1.5 percent in 2019 and 0.5 percent in 2020 for agencies “in the highest quartile of all counties … based on the number of Medicare home health episodes furnished per 100 individuals.” But in areas with “a population density of 6 individuals or fewer per square mile,” the add-on will be 4 percent in 2019, 3 percent in 2020, 2 percent in 2021 and 1 percent in 2022, the law says. All rural agencies not fitting in those two categories will see an add-on of 3 percent in 2019, 2 percent in 2020, and 1 percent in 2021.

One caller asked CMS when it will release the definitions of which counties fit into which categories. Expect the information to be issued in conjunction with the Home Health 2019 proposed Prospective Payment System rule, a CMS official responded. That rule is expected in by early July.

  • Claims adjustments. BBA 18 made the rural add-on retroactive to Jan. 1, but the add-on wasn’t reinstated in the claims system until April 2. The HHH Medicare Administrative Contractors are adjusting claims paid before that date retroactively with no action required by providers, a CMS source noted. The MACs have until Oct. 1 to finish the addon adjustments, but CMS hopes they will be finished “sooner,” he said.
  • HHQRP. You can learn more about Home Health Quality Reporting Program changes in a June 27 MLN provider education call, a CMS staffer said in the forum. The call will cover changes to Quality of Patient Care star ratings that will display on Home Health Compare. The call will be posted at
  • CAHPS surveys. Stay tuned for possible changes to the Spanish-language CAHPS survey CMS makes available. Spanish-language experts have reviewed the survey and found it “good,” but CMS is still deciding whether to make some changes, a CMS source told forum attendees.

Plus: The survey is now available in English, Spanish, Chinese, Russian, and Vietnamese, and soon in Armenian. CMS is open to making the form available in other language suggestions as well, the CMS staffer indicated in the call.

Source- SuperCoder

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