Recovery auditor (RAC) Connolly will investigate whether agencies complete OASIS assessments timely and whether they’re billing for services that should be covered under the hospice benefit.
 
A third new issue will look for incorrect payments in cases where a second home health episode was billed within 60 days from the start of another home health episode. That situation would result in a partial episode payment (PEP) adjustment. All three issues were approved by CMS Nov. 26, according to Connolly’s website.
 
More details on the OASIS and hospice issues from the Connolly website:
  • OASIS: This semi-automated review will identify situations where “[t]he OASIS was not completed within the appropriate time frame.”
  • Hospice: This is an automated review. “Services related to a Hospice terminal diagnosis provided during a Hospice period are included in the Hospice payment and are not paid separately,” Connolly notes.
 
Region C includes Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, Virgin Islands, Virginia and West Virginia.