CMS Process for Answering MDS Questions

The Centers for Medicare & Medicaid Services (CMS) has established a process for answering MDS questions and is requesting that providers contact their State RAI Coordinator with any questions and concerns involving MDS 3.0 coding and policy.  The State RAI Coordinator is equipped to answer provider questions and should return an answer to the provider within a reasonable amount of time – usually within 5 days.  If for some reason, the State RAI Coordinator cannot answer the question, they are instructed to contact a member of the RAI Panel.  When the RAI Panel cannot answer the provider question, only then is the question sent to the CMS Central Office.  The CMS Central Office will forward the answer back to the RAI Panel with a copy to the State RAI Coordinator for dissemination back to the provider.  If the provider does not agree with the answer given to them by their State RAI Coordinator, the provider can contact a member of the RAI Panel or their Regional Office to verify the response they received.  Providers are asked not to send questions directly to CMS Central Office personnel unless they have been requested to do so by CMS.  Virginia’s RAI Coordinator, Cil Bullard, can be reached at priscilla.bullard@vdh.virginia.gov or by phone at 804.367.2141.

A listing of State RAI Coordinators, Regional Office Contacts, RAI Panel members and Co-Chairs can be found in Appendix B of the RAI Manual.  The RAI Manual can be purchased from the AHCA Bookstore and can also be downloaded from the CMS website.  It is important that facilities read the manual before asking questions since many answers are found in the manual.  Facilities also need to ensure that they have the most up to date manual and associated errata documents.  Errata documents can be downloaded from the CMS’ website.