Home Health Line
11/17/2014

Agencies wishing to ensure accurate payment for OASIS-C1/ICD-9 assessments beginning Jan. 1, 2015 will need to make sure their quality managers, educators and clinical directors study and understand that four diagnosis groups will no longer be used in scoring in the PPS Grouper released by CMS Nov. 10.

 
11/17/2014

CMS plans to reduce or increase home health payments by 5% to 8% in five to eight states beginning in 2016, depending on the degree of quality performance achieved.

 
11/17/2014
CMS has removed the requirement for physicians to provide a face-to-face narrative. Below is a sample, revised encounter form that removes spaces for doctors to write narrative examples within their face-to-face documentation. This form could be a separate document that your agency provides doctors or this information could be captured in the plan of care. 
 
11/17/2014
by: DecisionHealth
Physicians were denied 37.3% of the time during the 476,307 instances in 2013 when they billed with TCM codes 99495 or 99496.
11/10/2014
The PPS final rule for 2015 — posted by CMS on Oct. 30 — eliminates the physician narrative and instead relies on patient information in the physician’s or facility’s files to determine patient eligibility for home health.
 
11/10/2014
CMS is following through with plans to simplify therapy reassessment requirements, and the final rule is less stringent than what was proposed. 
 
11/10/2014
You’ll no longer get case-mix points for 200 codes in the pulmonary, psych 1, psych 2 and blindness/low vision diagnosis categories as well as two OASIS items starting Jan. 1 — and CMS says the responsibility rests solely with the home health industry.
 
 
11/10/2014
Your agency’s quality and clinical managers better get familiar with the OASIS validation logs generated by CMS’ new Assessment Submission and Processing (ASAP) system. Those reports will be the key to preventing reduced payments for failure to meet minimum OASIS submission requirements.
 
11/10/2014
About 30% of physical therapy visits were provided by an assistant and about 15% of occupational therapy visits were provided by an assistant in 2013, CMS data show.
11/10/2014
CMS projects Medicare payments to agencies will be reduced by 0.30% — $60 million — in 2015, according to the final 2015 PPS rule.
 
 

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