CMS Clarifies Data Changes on OASIS submission
In light of a recent data breach that could compromise a beneficiary’s MBI, the Alliance submitted to the Centers for Medicare & Medicaid Services (CMS) the following question. Following the question is CMS’ response.
- Alliance question: I am requesting clarification on the impact changes/corrections to the OASIS assessment has on the timely submission of a previously submitted assessment. We anticipate that a number of beneficiaries will be receiving new MBIs due to the CMS and Wisconsin Physicians Service Insurance Corporation (WPS) MOVEIt data breach. This change could require the HHA to open a timely submitted OASIS assessment to change the MBI so that it matches the new MBI reported on the claim. If an HHA opens a previously submitted OASIS assessment, makes the correction, and resubmits the assessment, does the submission date change to reflect the last submission date? Or is the original submission date retained?
- CMS answer: At this time, as the MBI number reported in M0063 must match the MBI reported on the claim, continue to follow the instructions from the Medicare Claims Processing Manual. These instructions state that when there is a new MBI on a claim, M0063 – Medicare Number must be updated so that it matches the MBI number submitted on the claim. The instructions to update the MBI do not impact compliance with the 30-day submission requirement and do not result in a change to the original submission date of the OASIS.
Below is from the Medicare Claims Processing Manual, chapter 10, section 10.1.19 – Payment Adjustments – Applying OASIS Assessment Items to Determine HIPPS Codes
Note: Changes to a beneficiary’s Medicare Beneficiary Identifier (MBI) can affect the match. If an HHA becomes aware of a change to the MBI via the MBI look-up tool and uses the new MBI on their claim when the prior MBI was used on the OASIS, that will cause the claim to be returned. In these cases, HHAs should update item M0063 on the OASIS and then resubmit the claim.
