[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

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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

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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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[FR Doc. 99-15529 Filed 6-16-99; 9:00 am]
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