CMS sent out an email via the SNF listserve on the evening of October 20 notifying recipients of an MDS 3.0 submission and processing problem. This problem resulted in errors in the RUG-III and RUG-IV codes printed on facility Final Validation Reports, which could lead to improper reimbursement if the incorrect RUG value is included on a claim submitted for payment.
Although the problem led to the temporary shut down of the MDS 3.0 Assessment Submission and Processing System recently, the transmission system now remains in operation and all providers can continue to submit MDS 3.0 records. However, the editing of the submission files and generation of the Final Validation Reports has been temporarily stopped pending final testing of the reprogrammed editing and validation system.
CMS expects the release of all Final Validation Reports, including the revised reports for earlier submissions, to occur by 9:00 p.m. EST on October 22. Facilities that have already submitted MDS 3.0 data and received a Final Validation Report will have to check their CASPER shared folder for the revised reports. CMS urges providers to use the revised Final Validation Reports to verify their RUG-III and RUG-IV values to ensure their submitted claim for payment is correct.
Fortunately, providers will not be penalized for late MDS transmissions during this time and will only receive warning messages on validation reports for records submitted late. According to the CMS email, the Survey and Certification group has been notified that some MDS 3.0 assessments may be delayed due to this systems problem, and the Survey and Certification staff is expected to issue written policy instructions shortly.
The CMS email also provided the following instructions for facilities regarding their software:
- Providers using jRAVEN need to check the CMS website for an updated jRAVEN
- Non-jRAVEN users need to check with their vendor for software updates that address the issues identified
- It is recommended that all providers continue to check for software updates on a regular basis.
CMS would like providers to contact the QTSO Help Desk at (800) 339-9313 or email@example.com with any questions or concerns they may have about this MDS 3.0 submission and processing problem.