The last’ word on OASIS
HCFA’s final regulations go into effect
Six months after the Health Care Financing Administration (HCFA) suspended implementation of Outcome and Assessment Information Set (OASIS) regulations, they are back in force. While the overall program is the same, several modifications have been made that will provide home care with a modicum of regulatory relief.
First and foremost, only data on Medicare and Medicaid recipients of skilled home care must be transmitted. HCFA decided that for the time being at least, although home health agencies will be responsible for collecting the information, transmission of data on non-Medicare and non-Medicaid skilled care recipients will not be required. If such data are accidentally transmitted they will be rejected at the state level. When the regulations mandating transmittal for information on non-Medicare and non-Medicaid recipients of skilled care finally do kick in in 2000, HCFA has said it will not expect agencies to submit data retroactively. (See box, above right.)
Rep. Jim Ryun (R-KS) recently introduced HR 2246, the Medicare Home Health Care Relief Act of 1999, that would entirely exempt non-Medicare and private-pay patients from OASIS data collection. He proposed that a year after the implementation of the prospective payment system, the secretary of Health and Human Services would be required to submit a report providing a detailed evaluation of the quality of data collected on Medicare recipients, as well as an examination of whether a deadline extension in OASIS data submission would result in improved quality of care and data.
The issue of patient rights has also found its way into the revised regulations, whereby home health agencies are now mandated to notify patients (for whom OASIS data will be submitted) of their rights. These rights include:
• Patients are informed that OASIS data will be collected and for what purpose.
• Patients’ information is kept confidential and secure.
• Patients are informed that OASIS information will not be disclosed except for legitimate purposes as allowed under the Federal Privacy Act. Personally identifiable information will no longer be submitted to accrediting organizations such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), for example.
• Patients can refuse to answer a question.
• Patients can see, review, and request changes in their assessment.
Even as HCFA says this is the "final" version of regulations, trouble is brewing on the Congres-sional front if both Houses manage to pass the latest version of the medical records privacy bill. Currently, the Senate has begun to consider Sen. James Jeffords’ (R-VT) as-yet unnumbered bill, the Health Information Confidentiality Act, a piece of legislation that, were it to make it through committee, would require patients to "explicitly consent" to share information with caregivers.
Although several similar measures have failed to make it out of the Health, Education, Labor, and Pensions committee, the likelihood of this bill passing rapidly through the Senate is high despite various problems. Sticky points include how to deal with minors and what standards individuals must meet to file suit if their rights are violated. If Congress fails to pass some type of medical records privacy legislation by Aug. 21, 1999, Health and Human Services Secretary Donna Shalala is authorized to enact her own.
Date with OASIS |
|
Date |
Action |
| July 19 | Data collection/encoding begins for recipients of Medicare/Medicaid skilled care and non-Medicare/non-Medicaid skilled care. |
| Aug. 18 | Test for transmission of data of Medicare/Medicaid skilled care must be completed. |
| Aug. 25 | Final day for data transmission of Medicare/Medicaid recipients of skilled care to begin. |
| Spring 2000 | Encoding/transmission of data for non-Medicare/non-Medicaid skilled care begins data collection/encoding/transmission to begin for both Medicare/Medicaid and non-Medicare/non-Medicaid recipients of personal care. |
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