Fax Transmission of OASIS
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DEPARTMENT OF HEALTH &
HUMAN SERVICES
Health Care Financing Administration
Center for Medicaid and State Operations
7500 Security Boulevard
Baltimore, MD 21244-1850
DATE: September 20, 2000
FROM: Director, Survey and Certification Group, Center for Medicaid
and State Operations
SUBJECT: Fax Transmission of Outcome and Assessment Information Set (OASIS) -
Procedures Affecting Home Health Agencies (HHAs) and OASIS Requirements--INFORMATION
TO: Associate Regional Administrators, DMSO President,
Association for Health Facility Survey Agencies
The purpose of this memorandum is to provide guidance to HHAs and State survey agencies
concerning faxed transmission of OASIS or other patient identifiable information.
The use of electronic means of communication is acceptable in HHAs, if appropriate
safeguards are in place. The fax machine provides a fast and inexpensive method to send
and receive patient specific information, such as patient referrals and physician orders.
However, the use of fax transmission can open up the possibility that confidential patient
information can be transmitted or handled in a manner that is not secure and does not
protect the patient's confidential health
information. For example, the use of an incorrect fax number can allow the material being
transmitted to persons who are not legally authorized to have this information. Inasmuch
as the Health Care Financing Administration (HCFA) takes its responsibility seriously to
protect patient specific information once it has been transmitted to the State, we expect
HHAs to provide the same protections to OASIS data while it is maintained at the HHA.
The home health Condition of Participation (CoP) 42 CFR 484.11, Release of Patient
Identifiable OASIS information, requires that HHAs and agents acting on behalf of the HHA
in accordance with a written contract must ensure the confidentiality of all patient
identifiable information contained in the clinical record, including OASIS data, and may
not release patient identifiable information to the public.
It is the responsibility of the HHA to make sure that it has a written contract
providing its agent with the legal authority to encode and transmit OASIS assessment data.
The contract should also ensure that the agent holds all OASIS data confidential. Each HHA
that uses fax transmission of OASIS information should develop its own policies and
procedures to assure confidentiality of patient information, as well as, comply with
legal, regulatory and accreditation requirements. It is also the responsibility of the HHA
to make sure that OASIS assessment data is transmitted to its agent by a secure method.
If the HHA chooses to use facsimile transmission of OASIS data, guidelines for use of
facsimile transmission of OASIS data are provided below:
-
The HHA or agent should place fax machines in a secure area and limit access to them.
-
The HHA should identify one person in a department or unit to monitor incoming documents
on a fax machine, or to deliver the document information directly into a secured data base
system.
-
The HHA should outline appropriate written policies that safeguard that transmitted
OASIS information is sent to the appropriate person and verify the correct facsimile
number to which the OASIS data is being transmitted. This should include:
-
(a) use of the of a cover sheet, either electronic or hard copy, accompanying the faxed
information that specifies that the OASIS information is confidential and limits its use
to the terms of the written contract,
-
(b) that the person who is the legal authority for the receipt of the OASIS information
is prohibited from disclosing this information to any other party, any may use the data
only for the purposes outlined in the written contract, and
-
(c) the HHA should contact the agent to verify the correct fax number to use prior to
faxing.
The HHA should develop and enforce procedures to be followed in the case of a
misdirected transmission. This should include:
-
(a) a notice on the cover sheet that prohibits the disclosure, copying, or distribution
of the information by the unintentional receiver of the fax,
-
(b) a notice to the unintentional receiver of the fax to notify the sender immediately
if they have received this information in error to arrange for the return of the
information, and
-
(c) the name and phone number of the sender to contact.
A sample fax coversheet (PDF,
11 KB)
is attached for further guidance.
State survey agencies should follow the same guidelines outlined above when using fax
machines for doing such things as sending and receiving requests to correct errors to the
OASIS data base.
The guidance and recommendations provided in this memorandum apply to all accredited
HHAs that participate in Medicare and to HHAs that are required to meet the Medicare
Conditions of Participation, including Medicaid HHAs.
If you have any questions about these instructions, please contact Mary Weakland at
410-786-6835 or Tracey Mummert at 410-786-3398.
/s/ Steven A. Pelovitz
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