On October 28, 1999, the Proposed Rules for PPS were published in the Federal Register. The proposed ruling detailed case-mix category weights for each HHRG, labor and non-labor factors, and wage index factors to demonstrate how HCFA proposes to reimburse HHAs under the new PPS system effective 10/01/2000.

For HHACompliance.com Subscribers:
HHACompliance.com has provided all of the tools you need to start preparing your Agency for PPS. Your subscription to HHACompliance.com enables you to start
(1) calculating each patient's "grouper" or HHRG (home health resource group) and proposed reimbursement rate, (2) testing visit schedules and pathways to see what works best for your Agency, and (3) generating utilization reports that tell you how effective the visit schedules and pathways are working at keeping your costs down.

The grouper will determine the patient's proposed, preliminary reimbursement rate. HCFA will make adjustments to the reimbursement rate if the patient is (1) transferred or hospitalized, (2) requires more services, or (3) receives 4 visits or less during the 8 week episode. Even though HCFA has not made the final determination regarding rates, you will become familiar with the reimbursement method and have a close idea of how much you can expect to get paid.

You will be able to maintain each patient's initial and ongoing OASIS results, automatically determine patient groupers and reimbursement rates, and generate preliminary and final line-item electronic claims to submit to your RHHI using HHACompliance.com's OASIS Data Capture and Electronic Billing software. This on-line software will be available after HCFA publishes its final PPS ruling.

Using HHACompliance.com to manage OASIS and electronic billing will increase efficiency and cut overhead by eliminating duplicate data entry. If your staff use point-of-care electronics, they will also be able to manage OASIS at point-of-care using HHACompliance.com.