Chapter 8. PPS for Home Health
Agencies
home health agencies - answer provide skilled care to people in their homes, typically
people who are homebound; may be freestanding, or based in hospitals or other
healthcare organizations; must be licensed per state or local law
$18 billion - answer Medicare payments for HHA services total about _________
October 1, 2000 - answer When did HHPPS go into effect?
A & B – answer HHPPS is covered under Medicare _______
60 - answer beneficiaries can receive an unlimited number of episodes (_____ days
periods of care) so long as they continue to meet the coverage (eligibility) criteria
durable medical equipment - answer there is no cost sharing for HHPPS, except for a
20% coinsurance for?
60 - answer physicians must recertify the services at intervals of at least once every
_____ days
episode of care - answerwhat is the unit of payment for HHPPS?
DME and osteoporosis drugs - answerwhat is excluded from the HHPPS?
outcome assessment information set (OASIS) - answerin HHAs data are collected on
an instrument called?; collects data in six major domains: sociodemographic,
environment, support system, health status, functional status, behavior status; specific
timeframes from CMS
OASIS-C1 - answerwhat is the current version of OASIS that is being used?
seriousness - answerthe sequencing of the diagnoses should reflect the _________ of
each condition
principal - answerdiagnosis most related to the current plan of care
quality measures - answerCMS requires HHAs to collect and report ___________;
publicly posted to the CMS website; submission affects payment
Agencies
home health agencies - answer provide skilled care to people in their homes, typically
people who are homebound; may be freestanding, or based in hospitals or other
healthcare organizations; must be licensed per state or local law
$18 billion - answer Medicare payments for HHA services total about _________
October 1, 2000 - answer When did HHPPS go into effect?
A & B – answer HHPPS is covered under Medicare _______
60 - answer beneficiaries can receive an unlimited number of episodes (_____ days
periods of care) so long as they continue to meet the coverage (eligibility) criteria
durable medical equipment - answer there is no cost sharing for HHPPS, except for a
20% coinsurance for?
60 - answer physicians must recertify the services at intervals of at least once every
_____ days
episode of care - answerwhat is the unit of payment for HHPPS?
DME and osteoporosis drugs - answerwhat is excluded from the HHPPS?
outcome assessment information set (OASIS) - answerin HHAs data are collected on
an instrument called?; collects data in six major domains: sociodemographic,
environment, support system, health status, functional status, behavior status; specific
timeframes from CMS
OASIS-C1 - answerwhat is the current version of OASIS that is being used?
seriousness - answerthe sequencing of the diagnoses should reflect the _________ of
each condition
principal - answerdiagnosis most related to the current plan of care
quality measures - answerCMS requires HHAs to collect and report ___________;
publicly posted to the CMS website; submission affects payment