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Take Note: Indiana Medicaid Optional State Assessment Guidance

Posted Oct 7, 20191 min Read

Payment & Reimbursement
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Effective October 1, 2019, the Medicare SNF Prospective Payment System will transition to the Patient Driven Payment Model (PDPM) for Medicare reimbursement. As part of this transition the Centers for Medicare and Medicaid Services (CMS) has created the Optional State Assessment (OSA) and allowed states the option to utilize this new MDS assessment item set for state specific Medicaid reimbursement purposes.

The Office of Medicaid Policy and Planning (OMPP) has selected not to require the use of the OSA for assessment reference dates (ARD) of October 1, 2019 – September 30, 2020. Facilities should follow the MDS assessment schedule as required under the MDS 3.0 RAI Manual v.1.17.1.

Beginning October 1, 2020 OMPP will require all Medicaid certified nursing facilities to complete an OSA in conjunction with all OBRA and Medicare PPS assessments. Further guidance and clarification will be issued in the forthcoming months.

Any questions or concerns should be submitted to FSSA.IHCPReimbursement@fssa.IN.gov