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MDS Optional State Assessment Section is Optional for Texas NF Providers — No State or CMS Approval Needed to Submit

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As previously announced, HHSC has modified the Long-term Care Medicaid Information (LTCMI) in the Texas Medicaid & Healthcare Partnership (TMHP) Long-term Care Online Portal to open the Resource Utilization Group (RUG) section for data entry of RUG III required items missing from (Minimum Data Set (MDS) Omnibus Budget Reconciliation Act (OBRAs) with an assessment reference date (ARD) on and after Oct. 1, 2023.

All Texas nursing facilities with Medicaid contracts are required to complete all missing items in this RUG section for all OBRAs used in the Medicaid eligibility or reimbursement process. See the LTC Provider Bulletins webpage on the TMHP website for more information or call the TMHP LTC Help Desk at 800-626-4117 (select option 1 and then option 7) with questions.

Texas nursing facility providers have informed HHSC that they know the OSA can’t be used for Medicaid reimbursement, but the ability to complete OSAs and transmit them to the federal CMS Internet Quality Improvement and Evaluation System (iQIES) may help them with internal processes or systems.

The CMS iQIES Service Center has informed HHSC that until CMS adds a future setting to iQIES for states to allow\deny submission of the OSA, any provider may voluntarily complete and transmit OSA assessments to iQIES without needing state or CMS approval. Providers will have to decide for themselves whether using the OSA MDS record type and having that data in iQIES benefits their operational needs.

Texas has decided not to require the OSA.

Because HHSC does not require the OSA, providers voluntarily submitting OSA data to CMS iQIES should be aware that:

  • HHSC state systems have no ability to use the OSA record type, so have no access to that iQIES data.
  • HHSC staff can’t provide any support for OSA use, including completion, transmission or assistance with accepted records.
  • Providers must accept all responsibility for voluntary use of that record type and obtain their own support from non-HHSC sources.
  • OSA item A0300A “Is this assessment for state payment purposes?” must be set to 0 (for No).

Email LTCR Policy with questions about this alert.