Rhode Island Medicaid Transitioning to the OSA Effective 10/1/23

It’s official! Rhode Island Medicaid transitioning to the Optional State Assessment (OSA) effective 10/1/23; RI nursing facilities prepare for yet another change this fall.

RI Medicaid plans to adopt a PDPM model for Medicaid reimbursement in October 2025. In order to continue RUG-IV based payments until then, RI nursing facilities will be required to complete OSAs from 10/1/23-9/30/25. Between those dates, the OSA will be the only method to obtain a RUG calculation via the iQIES system.

Providers will need to confirm if OSAs have been enabled in their software. CMS stated that if a provider’s billing software is up to date with CMS’ current MDS specification, then OSAs will be completed using existing billing software.

Does your team have a plan to implement the OSA into your operations? Celtic offers support for facilities transitioning to the OSA; to promote your team’s understanding of OSA manual rules, including changes for new fiscal years, and systems to integrate this additional workload. Our associates provide analysis of software templates, and guidance for required modifications to capture clinical reimbursement elements for case mix.

Contact us today to discuss how we can help you navigate this transition.

About Lauren Videtto