On Friday, Oct. 20, Texas Health & Human Services (HHSC) released a critical announcement regarding Optional State Assessments (OSAs) in Texas: Per the iQIES Service Center, the OSA is no longer accepted by CMS in Texas because Texas does not use the OSA to calculate the Resource Utilization Group (RUG). See original correspondence from HHSC below.

At Simple, we recognize the importance of the OSA process for your operations and are actively exploring solutions to help providers manage the OSA/LTCMI process effectively. In fact, we’ve been working with HHSC for weeks to ensure that the missing Section O therapy fields on the LTCMI fields will be back online in SimpleCFS™ as of this Friday, Oct. 27, once the LTCMI is reactivated by TMHP.

What can Texas providers do now?

As the OSA situation continues to evolve between states and CMS/iQIES, here’s a suggested alternative workflow for Texas providers:

• Continue to use the OSA for internal RUG calculations only, but do not submit. (Consult with your clinical team to determine if this will be helpful to your processes.)
• Transmit your data as usual through the LTCMI to calculate and submit RUG scores. Though this will require some manual effort, it will ensure that your data is accurate and timely.

As always, Simple is here to help providers. We’re currently exploring options to automate and simplify and the OSA/LTCMI process going forward. We’ll provide updates and training on those new solutions as soon as possible.

Thanks for your understanding as we work through these CMS/HHSC changes! If you have questions, please reach out to our Support Team.