[Federal Register Volume 64, Number 117 (Friday, June 18, 1999)]
[Notices]
[Pages 32984-32991]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-15529]
[[Page 32983]]
_______________________________________________________________________
Part VI
Department of Health and Human Services
_______________________________________________________________________
Health Care Financing Administration
_______________________________________________________________________
Medicare and Medicaid Programs; Mandatory Use, Collection, Encoding,
and Transmission of Outcome and Assessment Set (OASIS) for Home Health
Agencies and Privacy Act of 1974; Report of New System; Notices
Federal Register / Vol. 64, No. 117 / Friday, June 18, 1999 /
Notices
[[Page 32984]]
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[HCFA-3020-N]
RIN 0938-AJ54
Medicare and Medicaid Programs; Mandatory Use, Collection,
Encoding, and Transmission of Outcome and Assessment Information Set
(OASIS) for Home Health Agencies
AGENCY: Health Care Financing Administration (HCFA), HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This notice announces to home health agencies (HHAs), State
survey agencies, Medicare and Medicaid beneficiaries, software vendors,
and the general public changes to and effective dates for OASIS
implementation. This notice announces the effective dates for the
mandatory use, collection, encoding, and transmission of OASIS data for
all Medicare/Medicaid patients receiving skilled services. For non-
Medicare/non-Medicaid patients receiving skilled services, there will
be no encoding and transmission until further notice, but HHAs must
conduct comprehensive assessments and updates at the required time
points. For patients receiving personal care only services, regardless
of payor source, we are delaying the requirements regarding OASIS use,
collection, encoding, and transmission until further notice. We expect
to begin implementation of OASIS for non-Medicare/non-Medicaid patients
receiving skilled care and for patients receiving personal care only
services in the Spring of 2000. A separate Federal Register notice will
be published with instructions at that time. In addition, software
changes described at the end of this notice are of interest to software
vendors and HHAs. Also, a companion notice concerning the OASIS System
of Records (SOR) is published elsewhere in this Federal Register and is
available via the HCFA Internet site (http://www.hcfa.gov).
EFFECTIVE DATES: This notice is effective on July 19, 1999.
FOR FURTHER INFORMATION CONTACT: Tracey Mummert, (410) 786-3398, Mary
Weakland, (410) 786-6835.
SUPPLEMENTARY INFORMATION:
I. Background
On January 25, we published a final regulation concerning the
collection of OASIS data as part of the comprehensive assessment (64 FR
3764), and an interim final regulation concerning transmission of OASIS
data (64 FR 3748). On April 7, 1999, we notified home health agencies
(HHAs), State survey agencies, Medicare and Medicaid beneficiaries,
software vendors, and the general public through the OASIS website that
we delayed the effective date of the OASIS data transmission
requirement. On April 27, 1999, we notified HHAs, State survey
agencies, Medicare and Medicaid beneficiaries, software vendors, and
the general public through the OASIS website, that the mandatory use,
collection, and encoding of OASIS were also delayed, due to lack of
Paperwork Reduction Act (PRA) clearances. A notice to this effect was
published in the Federal Register on May 4, 1999 (64 FR 23846).
The appropriate PRA clearances have now been obtained and privacy
procedures followed. Specifically, the PRA clearances for the final
rule establishing OASIS collection and use, and the interim final rule
for encoding and transmission have been obtained from the Office of
Management and Budget (OMB) and approval numbers assigned. The
respective OMB control numbers for these collections are 0938-0760 and
0938-0761 and the expiration dates are December 31, 1999. The Privacy
Act System of Records (SOR) Notice has been carefully drafted in
consultation with OMB and is published elsewhere in this Federal
Register.
II. OASIS Effective Dates
Effective July 19, 1999, all HHAs participating in the Medicare/
Medicaid programs are required to initiate the use of the standardized
assessment data set, OASIS, as summarized in the following chart:
Summary of Mandantory Collection, Encoding, and Transmission Dates for Oasis
----------------------------------------------------------------------------------------------------------------
Transmission effective
Patient classification Collection effective date Encoding effective date date
----------------------------------------------------------------------------------------------------------------
Medicare \1\/Medicaid \2\-- July 19, 1999............. July 19, 1999............. August 24, 1999.
Skilled.
Non-Medicare/Non-Medicaid July 19, 1999............. Spring 2000............... Spring 2000 \4\.
\3\--Skilled.
Medicaid \5\--Personal Care Spring 2000............... Spring 2000............... Spring 2000.
Only.
Non-Medicaid \3\--Personal Spring 2000............... Spring 2000............... Spring 2000 \4\.
Care Only.
Patients under age Excluded.................. Excluded.................. Excluded.
18; Patients
receiving pre & post partum
maternity services;
Patients
receiving only chore and
housekeeping services.
----------------------------------------------------------------------------------------------------------------
\1\ OASIS item (M0150) Current Payment Sources for Home Care: response 1 or 2.
\2\ OASIS item (M0150) Current Payment Sources for Home Care: response 3 or 4.
\3\ OASIS item (M0150) Current Payment Sources for Home Care: response 0, 5, 6, 7, 8, 9, 10, 11, or UK.
\4\ Data transmitted with masked identifiers
\5\ OASIS item (M0150) Current Payment Sources for Home Care: response 3.
III. Major Changes to OASIS
We are initiating OASIS activities as outlined in this notice which
include the following changes:
Administration of a standard notification to patients of
their privacy rights on admission to the HHA.
The addition of language in the SOR explaining limitations
on ``routine uses'' of data under the Privacy Act, so that personally
identifiable data will only be used where statistical information is
not sufficient. While this is usual practice, this language has not
traditionally been included in SOR notices. Among other changes,
personally identifiable data will no longer go to accrediting
organizations such as the Joint Commission on Accreditation of
Healthcare Organizations.
Limiting the ``routine uses'' of data to other Federal and
State agencies. Only those Federal and State agencies that (1)
contribute to the accuracy of HCFA's health insurance operations
including payment, treatment, and coverage, and/or (2) support State
agencies in the evaluations and monitoring of care provided by HHAs
will have access to OASIS data.
Major changes to the application of OASIS to private-pay
patients under OASIS. We have decided that information on non-Medicare
and non-Medicaid patients will not be
[[Page 32985]]
transmitted to the States or HCFA in personally identifiable form.
After careful attention to each question in OASIS, all
questions but one were retained on the grounds of assuring quality of
care and appropriate reimbursement. We did identify a sensitive
question on patient financial factors that we consider less critical to
achieving program goals, and this information will not be reported to
HCFA or the States.
Acceleration of efforts to encrypt data during
transmission, to provide yet another level of protection. We expect to
complete these efforts within a year.
Delay and phase-in the requirement to collect, encode, and
transmit OASIS data on patients receiving personal care only services
until further notice. This allows States and associations to adjust to
this requirement and allows us to evaluate issues pertaining to the
content and frequency of OASIS data collection relative to other
reporting requirements.
IV. OASIS Effective Dates in Detail
A. Medicare/Medicaid--Skilled
Effective July 19, 1999, for Medicare/Medicaid patients receiving
skilled services, HHAs must collect OASIS data as described in the
final regulation published on January 25, 1999 (64 FR 3764) concerning
use of the OASIS as part of the comprehensive assessment. This means
that for all Medicare/Medicaid patients receiving skilled services,
currently under the care of the agency or admitted to the agency on or
after July 19, 1999, HHAs must conduct comprehensive assessments and
updates at the required time points, and incorporate the OASIS data
set. The exception to this requirement are those patients receiving
prepartum and postpartum services, patients under age 18, and patients
receiving only housekeeping/chore services. OASIS data collection for
patients receiving only personal care services is delayed. HHAs must
collect start of care OASIS data and updates at the required time
points on new admissions to the HHA on or after July 19, 1999. In
addition, HHAs must collect OASIS data on patients already in service.
At the next appropriate time point, that is, resumption of care,
follow-up (that is, every 2 calendar months), transfer to an inpatient
facility (with or without agency discharge) and death at home, on or
after July 19, 1999, HHAs must collect OASIS data on all Medicare/
Medicaid patients receiving skilled services.
Effective July 19, 1999, for Medicare/Medicaid patients receiving
skilled services, HHAs must encode and lock their OASIS data (that is,
enter it into a computer), according to the requirements outlined in
the interim final rule published January 25, 1999 (64 FR 3748)
concerning transmission of OASIS data. This means that HHAs will encode
and lock start of care OASIS data and updates at the required time
points on new admissions to the HHA on or after July 19, 1999. In
addition, HHAs must encode and lock OASIS data on patients already in
service. At the next appropriate time point, that is, resumption of
care, follow-up (i.e., every 2 calendar months), transfer to an
inpatient facility (with or without agency discharge) and death at
home, on or after July 19, 1999, HHAs must encode and lock OASIS data
on all Medicare/Medicaid patients receiving skilled services. If the
HHA patient's services are to be paid for by Medicare or Medicaid, the
OASIS must be reported. There are no exceptions.
Effective August 18, 1999, HHAs must have completed a successful
transmission of test OASIS data. HHAs must successfully transmit test
OASIS data to the State agency for the purpose of determining
connectivity with the State OASIS system and receive a feedback report
on the test data. On August 19, 1999, States will begin to purge all
data on the State OASIS systems to allow for acceptance of production
data. Beginning August 24, 1999, HHAs must begin the transmission of
production OASIS data, that is, OASIS assessments completed, encoded
and locked the previous month.
EXAMPLE:
June 18, 1999--Publication of Federal Register Notice
July 19--August 18, 1999--Collection, encoding, and test
transmission begins
August 19-24, 1999--States purge test data
August 25, 1999--Production transmission begins
At least monthly thereafter, HHA transmissions must include all OASIS
data collected, encoded, and locked in the previous month.
B. Non-Medicare/Non-Medicaid--Skilled
Effective July 19, 1999, for non-Medicare/non-Medicaid patients
receiving skilled services, HHAs must conduct comprehensive assessments
and updates at the required time points as described in the final
regulation concerning use of the OASIS as part of the comprehensive
assessment published on January 25, 1999 (64 FR 3764), incorporating
the OASIS data set. HHAs must collect start of care OASIS data and
updates at the required time points on new admissions to the HHA on or
after July 19, 1999. In addition, HHAs must collect OASIS data on
patients already in service. At the next appropriate time point, that
is, resumption of care, follow-up (that is, every 2 calendar months),
transfer to an inpatient facility (with or without agency discharge)
and death at home, on or after July 19, 1999, HHAs must collect OASIS
data on all non-Medicare/non-Medicaid patients receiving skilled
services. However, we are not requiring encoding and transmission of
OASIS data at this time. These assessments must be retained as part of
the patient's clinical record in the HHA.
We expect the effective date for encoding and transmission of OASIS
data to begin in the Spring of 2000 for these patients. We will publish
a notice in the Federal Register with instructions at that time. In the
Spring of 2000, we will not expect HHAs to retroactively encode and
transmit OASIS data collected between July 19, 1999 and the Spring of
2000. If a HHA mistakenly transmits identifiable non-Medicare/non-
Medicaid data, we will reject this data at the State level. Rejection
at this point ensures that the data will not get into the Federal data
base until masking can be accomplished.
When the requirement to encode and transmit non-Medicare/non-
Medicaid patient data begins, HHAs must submit non-identifiable OASIS
data on these patients to the State agency. In this way, care provided
by the HHA can be evaluated for all patients of the agency, and not
just Medicare/Medicaid patients. However, these data will be not be
individually identifiable, but will be masked, as discussed below.
C. Medicaid/Non-Medicaid--Personal Care Only
For patients receiving only personal care services, regardless of
payor source, the effective date for OASIS implementation will be in
the Spring of 2000. We will publish a notice in the Federal Register
with instructions at that time. This is a delay in the implementation
of OASIS for these patients, which we originally outlined in the
preamble language to the January 25, 1999, regulation concerning use of
the OASIS as part of the comprehensive assessment.
At this time, HHAs are not required to collect, encode and transmit
OASIS data on patients receiving personal care or chore services unless
skilled care is also provided. HHAs are required to collect, encode and
transmit OASIS data
[[Page 32986]]
on patients who receive personal care and/or chore services only if
they also receive skilled care as described above, in addition to the
personal care services.
We are delaying the requirement to allow States and associations to
adjust to this requirement and allow us to evaluate issues pertaining
to the content and frequency of OASIS reporting relative to other
reporting requirements. In addition, this phase-in will allow HHAs more
time to prepare, upgrade their systems and integrate the OASIS data set
into their HHA and State specific instrument(s).
D. Masking
Masking refers to the concealing of individual data elements by the
provider. Patient identifiable information is not known to HCFA or the
OASIS State system. In OASIS terms, the data elements to be masked are
patient's name, social security number, Medicare number, and Medicaid
number. HHAs will keep the masked identifiers and the original data in
their records. For non-Medicare/non-Medicaid patients, HCFA and other
users will only be able to access data that does not contain any unique
identifiers, including, no name, social security number, Medicare
number and Medicaid number. With a consistent set of masked
identifiers, we are still able to do the longitudinal data linking
across patient care settings that is necessary for outcome measurement
and targeting patients for sampling during the State survey agency
certification review. At a minimum, we will follow the Federal
Government FIPS 46-2 Data Encryption Standard (DES).
Implementation of a masking system for non-Medicare/non-Medicaid
OASIS data is expected to occur in the Spring of 2000. The steps
required to accomplish this task include acquiring and evaluating tools
that follow the FIPS 46-2 DES, developing system specifications
required to incorporate the data masking tool, making the necessary
program changes to the HCFA-provided HAVEN data entry software, as well
as making other necessary changes to the OASIS State system and HCFA
data specifications. For HHAs not using HAVEN, we are providing the
opportunity for software vendors to make the required changes and
properly test their software by posting these data specifications on
the OASIS website in the near future. In addition, Year 2000 testing
must take place after all program changes have been incorporated, to
ensure that all systems are millennium compliant.
Until such time as a system of masking patient identifiers is
implemented, HHAs must assess and collect OASIS information from all
patients as required by the regulation but only encode and transmit
assessments with a Medicare/Medicaid payment source. To ensure only
assessments with a Medicare/Medicaid payment source are received by the
OASIS State system, the OASIS State system will reject all assessments
with a non-Medicare/non-Medicaid payment source.
E. Encryption
HHAs are required to send OASIS assessment data for patients who
have a Medicare or Medicaid payor source. Currently, these data are
sent to the respective State via a private telephone line that connects
directly into the OASIS State system. Although this is a relatively
secure method, additional protection may be provided by using
encryption. The use of 128-bit server certificates will provide strong
encryption for all users who use either the domestic or export version
of the latest leading browsers. HCFA plans to require this method in
the near future. Several Federal agencies such as the U.S. Department
of Commerce and the United States Postal Services have an expanded
license to issue 128-bit serve digital certificates.
A 128-bit encryption is standard for Netscape and Microsoft
Internet Explorer, the two major web browsers. Both products are
available free off the Internet or by mail for a nominal fee (less than
$20.00). There are some system requirements to run these browsers. This
includes a 32-bit operating system, that is, a computer that runs
Windows 95, 98, or NT. HCFA's Y2K compliance requirements also require
computers to have a 32-bit operating system. HHAs using the recommended
computer system requirements described in the interim final regulations
published on January 25, 1999 (64 FR 3738), concerning transmission of
OASIS data will not require additional changes. The projected date for
full 128-bit encryption transmission by HHAs is July 2000.
V. More Background on Changes to OASIS
A. Patient Rights
Existing regulations at 42 CFR 484.10, Conditions of Participation:
Home Health Agencies, specify that the patient has the right to be
informed of his or her rights with respect to care provided by the HHA.
Under the terms of this condition, HHA patients whose data will be
collected and used by the Federal government must receive a notice of
their privacy rights. These rights include: (1) the right to be
informed that OASIS information will be collected and the purpose of
collection; (2) the right to have the information kept confidential and
secure; (3) the right to be informed that OASIS information will not be
disclosed except for legitimate purposes allowed by the Federal Privacy
Act; (4) the right to refuse to answer questions; and (5) the right to
see, review, and request changes on their assessment. The statements of
patient privacy rights with regard to the OASIS collection (one for
Medicare/Medicaid patients, one for all other patients served by the
HHA) are included in this notice. They will also be available via the
HCFA Internet site (http://www.hcfa.gov). These statements may be
revised in accordance with the OMB Paperwork Reduction Act reapproval
process. Future revisions to these statements will be available via the
HCFA Internet site (http://www.hcfa.gov) and in other instructional
materials issued by HCFA.
Consumer testing was undertaken to determine whether Medicare
beneficiaries understood the overall message of the proposed Medicare
notice. The findings indicated that beneficiaries understood that the
notice was informing them about their rights relating to their personal
health care information and that these protections were good. In
addition, the majority of the beneficiaries found the notice's language
to be clear and easy to understand. For Medicare/Medicaid patients,
transmission of the assessment data to HCFA will be a condition for
payment and an essential tool in ensuring that both programs are paying
for quality health care services. As such, we are providing HHAs with a
copy of the notice that HHAs must incorporate into their admission
process.
Notice to Medicare/Medicaid Patients
HHAs must incorporate into their admission process for Medicare/
Medicaid patients Attachments A and B. Please refer to Attachment A--
Statement of Patient Privacy Rights (front), and Attachment B--Privacy
Act Statement--Health Care Records (back) of this notice for this
document.
Notice to Non-Medicare/Non-Medicaid Patients
Attachment C--Notice About Privacy for Patients Who Do Not Have
Medicare or Medicaid Coverage. This is the notice that HHAs must
incorporate into their admission process for non-Medicare/non-Medicaid
patients.
[[Page 32987]]
B. Administering the Assessment
The OASIS items should be answered as a result of the clinician's
total assessment process, not completed as a checklist during an
interview. Conducting a patient assessment involves both interview and
observation. Many times the two processes complement each other.
Information gained through interview is verified through observation.
Many clinicians begin the assessment process with an interview,
sequencing the questions to build rapport and gain trust and then
proceed with observation. Others choose to start the assessment process
with a familiar procedure such as taking vital signs to demonstrate
clinical competence to the patient before proceeding to the interview.
Very few OASIS data items rely solely on patient interview. In the rare
instance that an assessment cannot be made due to lack of patient
information, agencies must report the most appropriate response, based
on their professional judgement. Patients should not be forced to
cooperate with the assessment process.
If patients refuse to answer some questions that are part of the
OASIS assessment, the HHA may still deliver care to the patient as long
as it completes and submits the OASIS assessment to the best of its
ability.
Some changes have been made to the OASIS User's manual with regard
to the conventions involved in collecting and recording OASIS data in
the context of the comprehensive assessment process, particularly for
mental health assessments. These changes are available via the HCFA
Internet site (http://www.hcfa.gov). Alternately, these changes can be
accessed directly at www.hcfa.gov/medicare/hsqb/oasis/hhedtrng.htm
which is where the entire OASIS User's manual is available for
downloading free of charge. The purpose of these changes is to clarify
the definitions, instructions, and assessment strategies for selected
OASIS items, as follows:
Pages 8.2 and 8.3 of the OASIS User's Manual have been
modified to clarify the means of administering the OASIS items in the
context of the comprehensive assessment.
An introductory page (8.82) has been inserted into the
Item-by-Item Tips section regarding the assessment of mental and
emotional status, to provide further clarification concerning
observational and interview techniques that are effective in eliciting
the needed information while minimizing burden and intrusion on the
patient.
Item-by-item tips have been changed for item M0540 and
items M0560 through M0620. The purpose of these changes is to emphasize
observational techniques and to provide further guidance for clinicians
in assessing these characteristics especially in situations where
patients refuse to answer direct questions.
C. Financial Factors Limiting the Ability of the Patient/Family to Meet
Basic Health Needs (M0160)
HCFA is not requiring the transmission of OASIS data item M0160 to
the OASIS State system at this time. Because this data item assesses
the patient's ability to meet basic health needs, the HHA may need this
information to provide appropriate care. Therefore, HCFA requires the
collection, assessment and encoding of this item. HCFA's data entry
software (HAVEN Version 2.0) will blank out this encoded item as it is
prepared for transmission to the OASIS State system. Additionally, the
State system will reject this data item if it is inadvertently
transmitted to the OASIS State system from software that does not meet
HCFA specifications. Vendor software must be changed to accommodate
this and other changes. This is discussed elsewhere in this notice.
VI. Technical Information for HHAs and Vendors
A. Medicare/Medicaid Patients
At this time, HCFA requires the encoding and transmission of OASIS
information on patients who are receiving Medicare/Medicaid benefits.
This means that for patients who have selected a payor source of (1)
Medicare (traditional fee-for-service), (2) Medicare (HMO/managed
care), (3) Medicaid (traditional fee-for-service), or (4) Medicaid
(HMO/managed care) on OASIS item M0150, the HHA must collect, encode
and transmit all required OASIS information to the State agency. The
payor source for services provided as part of a Medicaid waiver or home
and community-based waiver (HCBW) program by a Medicare-approved HHA
are coded as (3) Medicaid (traditional fee-for-service) at item M0150.
B. Non-Medicare/Non-Medicaid Patients
For non-Medicare/non-Medicaid patients, the HHA will only assess
and collect OASIS as part of the comprehensive assessment and agency
medical record. Until such time as we develop and implement a system to
mask individual-level identifying data, encoding and transmission of
OASIS data items is not required for patients with payor sources other
than Medicare/Medicaid. Non-Medicare/non-Medicaid payor sources include
private insurance, private HMO/managed care, self pay programs funded
under the Social Security Act: for example, Title III, V, XX or other
Government programs.
C. Automation Information
Software Changes Made
The following section is of interest to software vendors and
includes the changes that have been made to accommodate requirement
changes for the OASIS:
1. HAVEN Software: HAVEN has changed the export function to allow
the user to select Medicare/Medicaid only assessments, non-Medicare/
non-Medicaid assessments only, or all assessments. The HAVEN export
function produces an ASCII text file from the HAVEN database. This file
meets the OASIS data specifications that must be transmitted to the
State agency. If a user selects Medicare/Medicaid only, as defined
earlier, all assessments with a reason for assessment (M0100) value of
1, 2, 3, 4, 5, and 9 and a payment source (M0150) value of 1, 2, 3, or
4, as well as, all assessments with a reason for assessment (M0100)
with a value of 6, 7, 8, and 10 will be selected for export. If a user
selects non-Medicare/non-Medicaid only, as previously defined, all
assessments with a reason for assessment (M0100) value of 1, 2, 3, 4,
5, and 9 and a payment source (M0150) value other than 1, 2, 3, or 4
will be selected for export. Therefore, the HHA controls assessments to
be sent to the State agency. As stated previously in this notice, these
procedures ensure that only assessments with a Medicare/Medicaid
payment source are received by the OASIS State system as the OASIS
State system will reject all assessments with a non-Medicare/non-
Medicaid payment source.
In addition to this change, HAVEN will blank out responses and move
spaces to the Financial Factors data item (M0160) on all assessments
prior to creating the export file. This data will remain in the
original format in the HHA database but will exist as spaces at the
State database. No data is collected at the State system on this item.
2. OASIS State System: The OASIS State system has been changed to
reject any assessment with a reason for assessment (M0100) value of 1,
2, 3, 4, 5, and 9 and a payment source (M0150) value other than 1, 2,
3, or 4. The validation report will reflect that an
[[Page 32988]]
assessment meeting the above criteria has been rejected.
In addition to this change, the OASIS State system will blank out
and move spaces to the Financial Factors data (M0160) on all
assessments prior to editing a file submitted by a HHA. This data will
remain in the original format in the HHA database but as spaces at the
State database. These changes in the HAVEN software are available via
the HCFA Internet site (http://www.hcfa.gov) in our revised HAVEN
software, version 2.0. Registered HAVEN users will be mailed a copy of
the revised HAVEN software, version 2.0 by July.
The following changes still need to be made to accommodate
requirement changes for the OASIS data base:
Software Changes Pending
1. HAVEN Software: The HAVEN software will need to incorporate all
requirements to mask designated identifiers for any assessment with a
reason for assessment (M0100) value of 1, 2, 3, 4, 5, and 9 and a
payment source (M0150) value other than 1, 2, 3, or 4. Specifications
for this are scheduled to be available via the HCFA Internet site
(http://www.hcfa.gov) by July 1, 1999, and scheduled to become
effective in April 2000.
2. OASIS State System: The OASIS State system will make the
necessary edits to reject any assessment with a reason for assessment
(M0100) value of 1, 2, 3, 4, 5, and 9 and a payment source (M0150)
value other than 1, 2, 3, or 4 that does not have the designated
identifiers masked. This edit is scheduled to be effective in April
2000.
HCFA Websites
Revisions and updates to OASIS implementation will be available via
the HCFA Internet site (http://www.hcfa.gov). Alternatively, the OASIS
Internet site is accessible directly at the following address:
www.hcfa.gov/medicare/hsqb/oasis/oasishmp.htm. This is the OASIS home
page. A summary of OASIS website content is available at this site.
OMB Review
In accordance with the provisions of Executive Order 12866 this
document was reviewed by the Office of Management and Budget.
(Catalog of Federal Domestic Assistance Program No. 93.778, Medical
Assistance Program; No. 93.773 Medicare--Hospital Insurance Program)
Dated: June 11, 1999.
Nancy-Ann Min DeParle,
Administrator, Health Care Financing Administration.
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