Beginning July 1, 2014, Medicare Advantage Organizations (MAO) and other entities will be required to submit Health Insurance Prospective Payment System (HIPPS) codes on all skilled nursing facility (SNF) and home health care encounter data submissions as a result of a new requirement from CMS.
CMS is clarifying that for 2014 DOS beginning on or after July 1, 2014, MAOs must submit HIPPS code on a SNF encounter that comes from the initial OBRA-required comprehensive assessment (Admission Assessment). SNF encounters with “from” dates July 1, 2014 or after that are submitted without a HIPPS code will be rejected. The OBRA-required tracking records and assessments are federally mandated for all residents of Medicare and/or Medicaid certified SNFs and nursing facilities
CMS is clarifying that for 2014 DOS beginning on or after July 1, 2014, MAOs must submit a HIPPS code on an HHA encounter that comes from the initial Outcome and Assessment Information Set (Start of Care assessment), or OASIS. OASIS assessments are federally mandated for all Medicare and/or Medicaid patients receiving skilled care from HHAs.