1                  HOSPICE CICS PRICER INSTALLATION GUIDE






          The 2013.0 Hospice Prospective Payment pricing subroutine (HOS

          CICS PRICER 2013.0) is furnished by the Centers for Medicare &

          Medicaid Services (CMS). The CICS PRICER 2013.0 will process for

          1998   THRU  2013.0 calculations.   The  responsibility   for

          installing, modifying, testing and  verifying the accuracy of

          this routine is that of the user.



          Please report any  problems or direct  any questions you  may

          have to Wendy Tucker of the Diviion of Institutional Claims

          (410)  786-3004.    You  can  also receive  clarification  of

          technical   matters if needed.   IN ORDER  TO ASSURE THAT THE

          PROBLEMS  YOU  MAY  EXPERIENCE  ARE  NOT  A  RESULT  OF  YOUR

          INTERFACE  PROGRAM(S), TEST  HOS CICS PRICER  USING  THE  CMS

          SUPPLIED TEST PROGRAMS (HOSOP130 AND HOSDR130).



          This subroutine has been tested by CMS.











                                    A

1                  HOSPICE CICS PRICER INSTALLATION GUIDE


                                TABLE OF CONTENTS

                                     VOLUME I

 Section     . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Page

 I.  Introduction

     I-1.   General  . . . . . . . . . . . . . . . . . . . . . . . . . I-1,2

     I-2.   Sysour Counts from HOSDR130  . . . . . . . . . . . . . . . I-3

 II. Installing the 2013.0 HOSPICE National Prospective Payment PRICER
            Subroutines (HOS PRICER)

     II-1.  General  . . . . . . . . . . . . . . . . . . . . . . . .  II-1

     II-2.  Copying the HOSPICE Files to Disk  . . . . . . . . . . .  II-1

     II-3.  Compiling and Linkage of HOSOP130, HOSDR130, HOSPR130
            HOS module . . . . . . . . . . . . . . . . . . . . . . .  II-1

     II-4.  HOSPICE CICS PRICER Assurance Testing  . . . . . . . . .  II-1

     II-5.  HOSPICE CICS PRICER Installation Requirements  . . . . .  II-2

 III. Using the 2013.0 HOSPICE National Prospective Payment
             HOS CICS PRICER Module (HOSPR130)

     III-1. General  . . . . . . . . . . . . . . . . . . . . . . . .  III-1

     III-2. Using HOSPR130 . . . . . . . . . . . . . . . . . . . . .  III-1


 IV. Using the 2013.0 HOSPICE (HOSDR130)

     IV-1.  General  . . . . . . . . . . . . . . . . . . . . . . . .  IV-1

     IV-2.  Using HOSDR130 . . . . . . . . . . . . . . . . . . . . .  IV-1

     IV-3.  Using HOSOP130 . . . . . . . . . . . . . . . . . . . . .  IV-1


 V.  PRICER Assurance Testing Using HOSOP130, HOSDR130

     V-1. General                                                      V-1

     V-2. Using HOSDR                                                  V-1

     V-3. Testing User Supplied Data Using HOSDR130                    V-1


                                    B

1                  HOSPICE CICS PRICER INSTALLATION GUIDE



 *************************************************************************
                                    VOLUME II
                                      FILES
 *************************************************************************
   NAME     -       DESCRIPTION

  FILE NAME  MU00.@BFN2699.HONDM130

   NAME     -       DESCRIPTION CICS PRICING
  BILL130   - 2013.0 HOSPICE TEST BILLING FILE
  CBSA130   - 2013.0 HOSPICE CORE BASED STATISTICAL AREA FILE - FY 2013
  HOSDR130  - 2013.0 HOSPICE DRIVER PROGRAM  - FY 2013
  HOSOP130  - 2013.0 HOSPICE OPEN    PROGRAM - FY 2013
  HOSPR130  - 2013.0 HOSPICE PRICING PROGRAM - FY 2013
  MANU130   - 2013.0 HOSPICE INSTALLATION MANUAL - FY 2013
  MSAH050   - 2013.0 HOSPICE METROPOLITAN STATISTICAL AREA FILE
  PROV130   - 2013.0 HOSPICE TEST PROVIDER FILE - FY 2013
  RATE130   - 2013.0 HOSPICE TESTING RESULTS OUTPUT FILE - FY 2013
  TESTJCL   - 2013.0 HOSPICE TEST JCL - FY 2013































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1                  HOSPICE CICS PRICER INSTALLATION GUIDE








                              LIST OF ILLUSTRATIONS


 FIGURE              . . . . . . . . . . . . . . . . . . . . . . . . .  Page


 1.1   Sysour counts from HOSDR130 . . . . . . . . . . . . . . . . . .   I-3

 1.2   Flowchart of HOS CICS PRICER system   . . . . . . . . . . . . .   II-3

 2.1   Layout of HOS CICS PRICER INSTALLATION TAPE/CARTRIDGE or NETWORK DATA
       MOVER (NDM) FILE  . . . . . . . . . . . . . . . . . . . . . . .   II-2

 3.1.a   Sample JCL - Download of the (NDM) File HOS CICS PRICER Installation
              file   . . . . . . . . . . . . . . . . . . . . . . . . .   III-2

 3.1.b   Contents of the (NDM) File HOS CICS PRICER Installation
              file   . . . . . . . . . . . . . . . . . . . . . . . . .   III-3


3.2 VS/COBOL II/COBOL FOR Z/OS JCL 
               Compile HOSOP130 HOSDR130 and HOSPR130 . . . . . . . .   III-4

3.3 VS/COBOL II/COBOL FOR Z/OS JCL - Link edit
                    HOSOP130, HOSDR130, AND HOSPR130 Modules  . . . .   III-5


 4.1   HOSPR130 Call List Arguments  . . . . . . . . . . . . . . . . .   IV-1

 4.2   Layout - Argument 1: HOS Data Sent to HOSPR130  . . . . . . . .   IV-2,3
                            HOS DATA RETURNED WITH RATE PAYMENT

 4.3   SAMPLE JCL TO EXECUTE HOSOP130  . . . . . . . . . . . . . . . .   V-2

 4.4   Layout - Argument 1: HOS Data Sent to HOSDR130  . . . . . . . .   V-3,4
                            HOS DATA RETURNED WITH RATE PAYMENT

 4.5   RATE FILE OUTPUT TEST HOSPICE FORMAT  . . . . . . . . . . . . .   V-5,6









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1                  HOSPICE CICS PRICER INSTALLATION GUIDE

 I.  INTRODUCTION
   I-1.  GENERAL

         Added  to Medicare  by TEFRA-82,  and implemented by  final regulations
 effective  11/1/83.   Hospice services  stress palliative  instead of  curative
 care, emphasizing relief of patient pain  and discomfort, with support services
 for the  family. Individual  must be  eligible for  Part A,  with an  attending
 physician (if available) and  the hospice medical director certifying  that the
 patient has an illness  with a life expectancy of  6 months or less if  it runs
 its normal  course. HOSPICE  PRICER refers  to a  program which  calculates the
 payment rate for hospice care on the basis of one of four prospectively-set,
 all-inclusive daily rates, based on the level of care provided on that day.

       LEVLE OF CARE AND DAILY PAYMENT RATES:

           1)  Routine Home Care
           2)  Continuous Home Care
           3)  Inpatient Respite Care
           4)  General Inpatient Care

   1.  HOSOP130 -This is  a test open  module and it  should  be used  for the
   installation  and testing phases of HOS CICS PRICER. This open program does
   all the FILE OPEN functions and calls the HOSDR130 module.

   2.  HOSDR130 -This is  a test driver  module and it  should be used  for the
   installation  and testing phases of HOS CICS PRICER. This driver program does
   all the I/O functions with the open files and calls the HOSPR130 module.

   3.  HOSPR130 --  This is the module where all of the edits and calculations
   are performed for years 1998 THRU 2013.0.
                                  ***
   The purpose of  this manual is  to provide Medicare Intermediaries  technical
   staff  with the  information necessary to  understand, install,  test, debug,
   support and, if necessary, modify the 2006 HOS CICS PRICER routine(HOSPR130).

   Hospice Services are required  to use the Calculation Module (HOSPR130)   for
   pricing National Hospice claims for HOSPICE  care. When in the plan of  care,
   hospice must provide  or arrange for certain other  services; PT, OT, Speech-
   language services; home health aide and homemaker services; medical supplies;
   drugs for pain and symptom relief; short-term inpatient care, including brief
   periods of respite care for primary  caregiver's relief; continuous home care
   of  8 or more  hours per  day during  crisis period.  Medicare intermediaries
   flexibility in the manner in which  it may be installed. The HOSPR130  Module
   is intended  to execute  as a subroutine  (Called) of  the HOS  PRICER Driver
   Program  (HOSDR___)  or of  an Intermediary  written inter-face  program. The
   HOSPR130 module  can execute as stand-alone  routine, if they are  passed the
   necessary data.




                                    I-1


1                  HOSPICE CICS PRICER INSTALLATION GUIDE

   Included with this documentation  is a HOSPICE CICS PRICER NDM FILE. This NDM
   File  contains all files  that should  be  needed to execute HOS CICS PRICER.
   The  HOSPR___  pricing program, a test open and driver (HOSOP__ and HOSDR___)
   programs, a test HOS  file, and the  expected test  results  are  included on
   the NDM file.   These can be  useful to assure  that the HOS  CICS  PRICER is
   executing properly.

   In preparing this manual, the following assumptions were made:

   1.  The reader  is familiar with IBM 370  Principals of Operation as well  as
       VS/COBOL II/ COBOL FOR Z/OS, and OS JCL.

   2.  The datasets required by HOS CICS PRICER will be copied to disk and
       Catalogued according to your data center conventions.

   3.  HOSPR130  will be installed in the Intermediaries system at a point where
   it receives fully edited data.


































                                   I-2

1                  HOSPICE CICS PRICER INSTALLATION GUIDE





   I-2.  SYSOUR COUNTS FROM HOSDR130


 HOSPICE PROGRAM VERSION ==> HOSOPXX.X (HOSOP program being used)
 HOSPICE PROGRAM VERSION ==> HOSDRXX.X (HOSDR program being used)
 HOSPICE PROGRAM VERSION ==> HOSDRXX.X (HOSPR program being used)

 INPUT  COUNTS FOR PROVIDER FILE ===> 00000 (Total input provider records)
 INPUT  COUNTS FOR BILL FILE     ===> 00000 (Total input hospice records)
 OUTPUT COUNTS FOR RATE FILE     ===> 00000 (Total rate file records)

                  Figure 1.1:  SYSOUR COUNTS FROM HOS__ PROGRAM.


==========================================================================
                     -------
                    ! HOSOP !
                     -------
                        !                      -------
                        !               +---> ! CBSAX !
                        !    -------    !      -------
                        +-> ! HOSDR ! <-!
                             -------    !      ------
                                !       +---> ! MASX !
                                !       !      ------
                                !       !
                                !       !      ------
                                !       +---> ! PROV !
                                !              ------
                                !
                              --+---
                            ! HOSPR !
                             -------


                 Figure 1.2: Flowchart of Pricer System.

 ==========================================================================













                                        I-3


1                  HOSPICE CICS PRICER INSTALLATION GUIDE

 II.  INSTALLING THE 2013.0 HOSPICE PROSPECTIVE PAYMENT
        SUBROUTINES (HOS CICS PRICER)

   II-1.  GENERAL

       A.  Installing the HOS CICS PRICER 2013 consists of the following steps:

           1.  Copy files 1 through 19 to disk,  (Figure 2.1).
           2.  Compile  and link HOSOP130, HOSDR130, and the calculation module
               HOSPR130.
           3.  Perform assurance testing.
           4.  Install HOSPICE  PRICER 2013.0 in production.


 ** NOTE:      HOSOP,  HOSDR,  &  HOSPR modules are written in VS/COBOL II/COBOL
               for Z/OS &  were  developed and tested on an IBM 3090. Installing
               this  software  on  equipment  that  is  not  IBM compatible will
               require program modifications.

   II-2.  COPYING THE HOS CICS PRICER FILES TO DISK

       A.  HOS CICS PRICER installation NDM file process.

1. The files contained on the HOS  CICS PRICER Installation NDM file
were created with the  IBM  IEBGENER utility.   The files  may be
copied to  disk  using any  utility capable  of  copying a  fixed
length record data set.
           2.  The HOS CICS PRICER  NDM  file  contains the installation manual,
               the  program  source  code and  data  files  necessary to install
               PRICER. The NDM file is  a disk  file  transmitted  via  the  NDM
               system containing nineteen files. The files and their block size,
               logical  record  length and  description are shown in Figure 2.1.
               Figure 3.1 shows sample JCL for downloading the NDM files to disk
               files for processing.


   II-3.  COMPILING AND LINKAGE OF HOSOP130, HOSDR130, & HOSPR130.

       A.  All programs were developed to use VS/COBOL II /COBOL for Z/OS.
       B.  The HOSPR130  Module is  intended  to be  Called  by a  user  written
           interface  program  or to  be  Called  by HOSDR130.  HOSPR130  may be
           dynamically loaded or the user may  INCLUDE the HOSPR130 PROGRAM when
           linking to the user interface module.
       C.  HOSOP130 Opens all files and Calls HOSDR130.
       D.  HOSDR130  "Calls"  the  HOSPR version  HOS CICS PRICER  Module.  When
           linking HOSDR, the user should include HOSPR load module.
       E.  Sample JCL for  compiling and  linking HOSOP, HOSDR, and HOSPR Module
           is shown in Figures 3.2 and 3.3 for VS/COBOL II/COBOL for Z/OS.





                                   II-1

1                  HOSPICE CICS PRICER INSTALLATION GUIDE

II-4.  HOS CICS PRICER ASSURANCE TESTING

       A.  It  is the user's  responsibility to assure that the  HOS CICS PRICER
           Is  executing  properly at  the user site.   The quickest way to test
           HOSPR is to execute HOSDR using the HOS Test file (See Sect. V).

   II-5.   HOS CICS PRICER INSTALLATION REQUIREMENTS

   HOS CICS PRICER 2007 must be installed prior to calculate rates for HOSPICE.

  -------------------------------------------------------------------------
 !        !          !        !        !                                   !
 ! FILE # ! FILE NAME!  LRECL ! BLKSIZE!  DESCRIPTION                      !
 !========!==========! =======!========! ==================================!
 !        !          !        !        !                                   !
 !   1    ! MANU130  !   80   !  9040  !  HOS CICS PRICER MANUAL FOR 2013.0!
 !--------!----------!--------!--------!-----------------------------------!
 !   2    ! HOSOP130 !   80   !   800  !  Test open program source       !
 !        !          !        !        !  code for 1998 THRU 2013.0        !
 !--------!----------!--------!--------!-----------------------------------!
 !   2    ! HOSDR130 !   80   !   800  !  Test driver program source     !
 !        !          !        !        !  code for 1998 THRU 2013.0        !
 !--------!----------!--------!--------!-----------------------------------!
 !   3    ! HOSPR130 !   80   !   800  !  Calculation program source       !
 !        !          !        !        !  code for 1998 THRU 2013.0        !
 !--------!----------!--------!--------!-----------------------------------!
 !   4    ! BILL130  !   135  !  135   !  INPUT TEST FILE                  !
 !--------!----------!--------!--------!-----------------------------------!
 !   5    ! TESTJCL  !   80   !   800  !  TEST JCL                         !
 !--------!----------!--------!--------!-----------------------------------!
 !        !          !        !        !  (PRODUCTION FILE)                !
 !   6    ! MSAH050  !   50   !   500  !  MSA FILE  --  ONLY FOR HOSPICE   !
 !        !          !        !        !  (ALL YEARS) ENDING WITH 2005     !
 !--------!----------!--------!--------!-----------------------------------!
 !   7    ! PROV080  !  240   !  9600  !  PROVIDER TEST FILE               !
 !--------!----------!--------!--------!-----------------------------------!
 !   8    ! RATE090  !  135   !  135   !  Expected Test Results            !
 !--------!----------!--------!--------!-----------------------------------!
 !   9    ! CBSA130  !  80    !  800   !  CBSA FILE STARTING WITH 2007     !
 !--------!----------!--------!--------!-----------------------------------!
 !  10    ! PROVR01  !        !        !  PROVIDER REGION FILE 1 THRU 10   !
 !  THRU  !  THRU    !  240   !  2400  !                                   !
 !  19    ! PROVR10  !        !        !                                   !
 !--------!----------!--------!--------!-----------------------------------!


   Figure 2.1:  Layout of HOSPICE CICS PRICER NETWORK DATA MOVER (NDM) FILE






                                    II-2

1                  HOSPICE CICS PRICER INSTALLATION GUIDE

   III. USING THE 2013.0 HOSPICE CICS NATIONAL PROSPECTIVE PAYMENT PRICER
        SUBROUTINE (HOSPR)

   III-1.  GENERAL

   The purpose of the HOS CICS PRICER subroutine (HOSPR) is  to provide the user
   with calculated rates for Hospice services.

   The open (HOSOP) opens all the files then calls the driver  program (HOSDR)
   which  performs  the I/O  functions.  Then  HOSDR  calls HOSPR and passes the
   necessary data  or  a user written interface program calls HOSPR supplying it
   with the necessary  data.   HOSPR  will calculate  the  payment  rate for the
   Hospice services  for the  data  elements passed to it.  It  will  return the
   payment  rate  amount &  other data used in pricing or error codes if pricing
   could not be properly executed.  Since HOSPR expects fully edited and audited
   data, it performs only  rudimentary  data edits. It is the  responsibility of
   the Provider to assure the accuracy of  the  data  that  is  submitted to the
   HOSPR subroutine.

   III-2.  USING HOSPR
   Using HOSPR for batch requires:

       1.  Installing HOS CICS PRICER as specified in Section II.

       2.  The program  HOSDR or  a user  written interface program is executed
           from HOSOP. It  looks  up  data  on  the necessary files and then it
           passes  the proper data to HOSPR.

       3.  Execute  HOSOP  or  a  user  written interface program that opens the
           files and calls HOSDR program.


   The HOSPR130 module  can execute  independently if a  user written  interface
   program supplies the necessary data.



















                                    III-1

1                  HOSPICE CICS PRICER INSTALLATION GUIDE

 //LOAD    PROC FB=FB,PREF='XX.XXXX',DSN=DATA040
 //COPY    EXEC PGM=IEBGENER
 //SYSPRINT DD SYSOUT=A
 //SYSIN    DD DUMMY,DCB=BLKSIZE=80
 //**    SYSUT1 => WILL BE THE NDM FILE FROM CMS   ***
 //SYSUT1   DD DISP=OLD,DSN=&PREF..HOSPRICE.&DSN(&MEMBER),
 //   DCB=(RECFM=FB,LRECL=&LRECL,BLKSIZE=&BLK)
 //SYSUT2   DD DSN=&PREF..HOSPRICE.&MEMBER,
 //   DISP=(NEW,CATLG,DELETE),UNIT=SYSDA,
 //   SPACE=(&BLK,(2500),RLSE),
 //   DCB=(RECFM=&FB,LRECL=&LRECL,BLKSIZE=&BLK)
 //PEND
 //MANUAL EXEC LOAD,LRECL=80,BLK=9040,MEMBER=MANU130,FB=FBA
 //HOSOP  EXEC LOAD,LRECL=80,BLK=800,MEMBER=HOSOP130
 //COPY.SYSUT2 DD DSN=&PREF..HOSPRICE.&MEMBER..COBOL
 //HOSDR  EXEC LOAD,LRECL=80,BLK=800,MEMBER=HOSDR130
 //COPY.SYSUT2 DD DSN=&PREF..HOSPRICE.&MEMBER..COBOL
 //HOSPR  EXEC LOAD,LRECL=80,BLK=800,MEMBER=HOSPR130
 //COPY.SYSUT2 DD DSN=&PREF..PRICER.&MEMBER..COBOL
 //BILL090  EXEC LOAD,LRECL=135,BLK=135,MEMBER=BILL130
 //PROV080  EXEC LOAD,LRECL=240,BLK=9600,MEMBER=PROV130
 //MSAH050  EXEC LOAD,LRECL=50,BLK=500,MEMBER=MSAH050
 //TESTJCL  EXEC LOAD,LRECL=80,BLK=800,MEMBER=TESTJCL
 //RATE080  EXEC LOAD,LRECL=135,BLK=135,MEMBER=RATE080
 //CBSA130  EXEC LOAD,LRECL=80,BLK=800,MEMBER=CBSA130
 //REG1
     THRU   EXEC LOAD,PREF=XX.XXXX,FILE=10,DSN=PROVR01,LRECL=240,BLK=2400
 //REG10                              (THRU 19)

   **NOTE:     Supply your own JOB card and apply your data center's standards.

 Figure 3.1.a:  Sample JCL - NDM FILE disk download of the HOS PRICER
                Installation NDM FILE



















                                        III-2



1                  HOSPICE CICS PRICER INSTALLATION GUIDE

File Name: MU00.@BFN2699.HONDM130
           PDS Member Names

              NAME
             BILL130
             CBSA130
             HOSDR130
             HOSOP130
             HOSPR130
             MANU130
             MSAH050
             PROV130
             RATE130
             TESTJCL









 Figure 3.1.b:  Sample Contents of the NDM File


























                                        III-3


1                  HOSPICE CICS PRICER INSTALLATION GUIDE

 //ALOC     EXEC PGM=IEFBR14
 //SYSPRINT DD SYSOUT=A
 //DD1      DD DSN=XX.XXXX.HOSTEST.LOAD.XXXXXXXX,
 // DISP=(NEW,CATLG,DELETE),UNIT=SYSDA,
 // SPACE=(TRK,(15,3,3)),
 // DCB=(RECFM=U,BLKSIZE=3130,DSORG=PO)
 //*
 //COMPLOAD EXEC COB2UCL,
 // PARM.COB2=(APOST,NODYNAM,LIB,RES,NONAME,AWO,OFF,TERM,
 //     X,'TRUNC(BIN)',NOADV,NOOPT,DUMP,OBJ,'DATA(24)')
 // PARM.LKED=(LIST,NOADV,NOOPT,XREF,LET,MAP,'AMODE(24)')
 //COB2.SYSIN   DD DSN=XX.XXXX.HOSTEST.XXXXXXXX.COBOL,DISP=SHR
 //COB2.SYSTERM DD SYSOUT=A
 //LKED.SYSLMOD DD XX.XXXX.HOSTEST.LOAD.XXXXXXXX,DISP=SHR
 //LKED.SYSUT1  DD UNIT=SYSDA
 /*

================OR FOR MORE RECENT COBOL ======================================

 //*********************************************************
 //STEPOPN   EXEC  IGYWCL,PARM=(DYNAM,NORENT)
 //COBOL.SYSIN  DD DSN= XX.XXXX.HOSTEST.XXXXXXXX.COBOL,DISP=SHR
 //LKED.SYSLMOD   DD DSN= XX.XXXX.HOSTEST.LOAD.XXXXXXXX,DISP=SHR
 //*********************************************************

   **NOTE: Supply your own JOB card and apply  your data center's standards. Run
           once for each COBOL Program.

   **NOTE:     Parm card information may vary by your data center.

 Figure 3.2:  Sample JCL - Creates load modules for HOSOPs, HOSDRs and HOSPRs.

 ------------------------------------------------------------------------------





















                                       III-4

1                  HOSPICE CICS PRICER INSTALLATION GUIDE

 //ALOC    EXEC PGM=IEFBR14
 //SYSPRINT  DD SYSOUT=A
 //DD1      DD DSN=XX.XXXX.HOSTEST.LOAD.HOSDR130,DISP=(,CATLG,DELETE),
 // UNIT=SYSDA,SPACE=(TRK,(15,3,3)),
 // DCB=(RECFM=U,BLKSIZE=13040,DSORG=PO)
 //*
 //COMPLOAD EXEC COB2UCL,
 // PARM.COB2=(APOST,NODYNAM,LIB,RES,NONAME,AWO,OFF,TERM,
 //      X,'TRUNC(BIN)',NOADV,NOOPT,DUMP,OBJ,'DATA(24)')
 // PARM.LKED=(LIST,NOADV,NOOPT,XREF,LET,MAP,'AMODE(24)')
 //COB2.SYSIN   DD DSN=XX.XXXX.HOSTEST.HOSDR130.COBOL,DISP=SHR
 //COB2.SYSTERM DD SYSOUT=A
 //LKED.SYSLMOD DD XX.XXXX.HOSTEST.LOAD.HOSDR130,DISP=SHR
 //LKED.SYSIN DD *
  NAME HOSTEST2(R)

================OR FOR MORE RECENT COBOL ======================================

 //ALOC    EXEC PGM=IEFBR14
 //SYSPRINT  DD SYSOUT=A
 //DD1      DD DSN=XX.XXXX.HOSTEST.LOAD.HOSDR130,DISP=(,CATLG,DELETE),
 // UNIT=SYSDA,SPACE=(TRK,(15,3,3)),
 // DCB=(RECFM=U,BLKSIZE=13040,DSORG=PO)
 //*
 //*********************************************************
 //STEPOPN   EXEC  IGYWCL,PARM=(DYNAM,NORENT)
 //COBOL.SYSIN  DD DSN= XX.XXXX.HOSTEST.HOSDR130.COBOL,DISP=SHR
 //LKED.SYSLMOD   DD DSN= XX.XXXX.HOSTEST.LOAD.HOSDR130,DISP=SHR
 //*********************************************************


   **NOTE: Supply your own JOB card and apply your data center's   standards.
   **NOTE: Parm card information may vary by your data center.

 Figure 3.3:  Sample JCL - Linkedit HOSDR.



                                     III-5

1                  HOSPICE CICS PRICER INSTALLATION GUIDE

 IV.  Using the 2013.0 HOS Prospective Payment Subroutine (HOSDR130)

   IV-1.   GENERAL

   HOSDR is a batch driver program that performs the following:

   1.  Calls the 2013.0 calculation module which will process 1998 THRU 2013.0.
   2.  Passes the necessary data to calculate a payment rate.
   3   Passes the necessary data back to HOSDR130 to print the results.

   IV-2.   USING HOSDR

   The user can execute HOSDR using these arguments (data groups).
   Figure  4.1  shows  the   argument  list  components  for  HOSPR   and  the
   requirements  for  argument  inclusion.    Also,  Figure  4.1  shows  which
   subsequent figure shows the format of each argument.

  ---------------------------------------------------------------------
 !                                                        !            !
 ! CALL  HOSPR130                                         !   FORMAT   !
 !      USING                                             !            !
 ! ====================================================================!
 !                                                        !            !
 !  Data elements from HOS   (HOSPICE TESTE FILE)         !  Fig. 4.2  !
 !--------------------------------------------------------!------------!

   FIGURE 4.1: HOSPR Call List Arguments






















                                   IV-1

1                  HOSPICE CICS PRICER INSTALLATION GUIDE

  ------------------------------------------------------------------------
 !                              !         !      !         COBOL          !
 !          FIELD               !   LOC   ! SIZE !----------------------  !
 !                              !         !      !   PICTURE  !   USAGE   !
 !==============================!=========!======!============!=========  !
 !                              !         !      !            !           !
 ! NATIONAL PROVIDER            !         !      !            !           !
 !    IDENTIFIER                !  1-10   !  10  ! X(10)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! PROVIDER NUMBER (OSCAR)      !  11-16  !  6   ! X(06)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! FROM EFFECTIVE DATE          !  17-24  !  8   ! X(08)      ! CCYYMMDD  !
 !------------------------------!---------!------!------------!-----------!

        NOTE ***   REDEFINED FIELD
 !------------------ ------------------------------------------------------!
 ! PROVIDER MSA CODE            !  25-28  !  4   ! X(04)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! PROVIDER LUGAR               !  29     !  1   ! X(01)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 !  NOTE ****PROVIDERS CBSA CODE REDEFINES POSITIONS 25-29                !
 !                                                                        !
 ! PROVIDER CBSA CODE           !  25-29  !  5   ! X(05)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!

        NOTE ***   REDEFINED FIELD
 !------------------------------------------------------------------------
 ! BENE'S MSA CODE              !  30-33  !  4   ! X(04)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! BENE'S LUGAR                 !  34     !  1   ! X(01)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 !  NOTE ****BENES CBSA CODE REDEFINES POSITIONS 30-34                   !

 !                                                                        !
 ! BENE'S CBSA CODE             !  30-34  !  5   ! X(05)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!

 !------------------------------------------------------------------------!
 ! PROVIDER'S WAGE INDEX        !  35-40  !  6   ! 9(02)V9(04)! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! BENE'S WAGE INDEX            !  41-46  !  6   ! 9(02)V9(04)! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!

        CONTINUES NEXT PAGE






                                      IV-2

1                  HOSPICE CICS PRICER INSTALLATION GUIDE


   ------------------------------------------------------------------------
 !                              !         !      !         COBOL          !
 !          FIELD               !   LOC   ! SIZE !----------------------  !
 !                              !         !      !   PICTURE  !   USAGE   !
 !==============================!=========!======!============!===========!
 ! GROUP1 -- REVENUE CODE       !  47-50  !  4   ! X(04)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP1 -- UNITS              !  51-57  !  7   ! 9(07)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP1 -- THEIR PAYMENT      !  58-65  !  8   ! 9(06)V99   ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP2 -- REVENUE CODE       !  66-69  !  4   ! X(04)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP2 -- UNITS              !  70-76  !  7   ! 9(07)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP2 -- THEIR PAYMENT      !  77-84  !  8   ! 9(06)V99   ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP3 -- REVENUE CODE       !  85-88  !  4   ! X(04)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP3 -- UNITS              !  89-95  !  7   ! 9(07)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP3 -- THEIR PAYMENT      !  96-103 !  8   ! 9(06)V99   ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP4 -- REVENUE CODE       !  104-107!  4   ! X(04)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP4 -- UNITS              !  108-114!  7   ! 9(07)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP4 -- THEIR PAYMENT      !  115-122!  8   ! 9(06)V99   ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! RETURNED DATA FROM HOSPR130  !  123-130!  8   ! 9(06)V99   ! DISPLAY   !
 !    PAYMENT AMOUNT            !         !      !            !           !
 !------------------------------!---------!------!------------!-----------!
 ! RETURNED DATA FROM HOSPR130  !  131-132!  2   ! X(02)      ! DISPLAY   !
 !    RETURN CODE               !         !      !            !           !
 !------------------------------!---------!------!------------!-----------!
 ! FILLER                       !  133-135!  3   ! X(03)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!

   FIGURE 4.2:        Call List Argument # 1
                      BILL Data Sent to HOSPR
                      RETURNS WITH RATE PAYMENT











                                        IV-3

1                  HOSPICE CICS PRICER INSTALLATION GUIDE


 V.    HOS CICS PRICER ASSURANCE TESTING USING HOSOP130 & HOSDR130

   V-1.    GENERAL

   It  is  the responsibility  of the user  to assure  that  HOS  CICS PRICER is
   Executing properly at the user's site.  HOSOP130 and HOSDR130 are provided by
   CMS in order to facilitate that testing.

   Instructions  for  installing  HOSOP130  &  HOSDR130  and  loading  the  Test
   HOSPICE can be found in Section II.

   HOSOP130 & HOSDR130 are a batch programs that perform the following:

   1.  HOSOP130 Opens and loads the provider, MSA and CBSA files to memory

   2.  Reads the Test HOS Billing File.

   3.  Calls HOSDR___ using the arguments in FIGURE 4.2.

   4.  Prints the results.

   Your test results can be compared to the Expected Test Results report located
   in file 8. You can also build your own test data and submit it to HOSDR130.

   V-2.    USING HOSDR130

       A.  VS/COBOL II/COBOL for Z/OS
           Using HOSDR130 for batch HOS CICS PRICER testing requires three
           steps:

           1.  Install HOS CICS PRICER as specified in Section II

           2.  VS/COBOL II/COBOL FOR Z/OS -- Execute  HOSDR130 using the test
               file  (see Figure 4.3 of sample JCL).

           3.  Compare the printed results to the Expected Test Results
               (Figure 2.1 -- FILE #8.)

       If any discrepancies  occur, check  to assure that  the installation  and
       testing instructions were carefully followed.  If so, contact CMS as soon
       as possible.

   V-3.    TESTING USER SUPPLIED DATA USING HOSDR130

       The Input Test HOS File may  not contain all probable situations that  an
       Medicare Intermediary may encounter.  It is a sound practice for the user
       to build their own test data for inclusion in the HOSDR130 test.

       The user will be required to build A test file:

           1.  The input test BILL File (see Figure 4.2)


                                        V-1

1                  HOSPICE CICS PRICER INSTALLATION GUIDE


 //HOSTEST2 PROC LIB=SYS1.COB2LIB,PREF=
 //PRICER   EXEC PGM=HOSTEST2
 //STEPLIB  DD DSN=&PREF..HOSTEST.LOAD.HOSOP130,DISP=SHR
 //         DD DSN=&PREF..HOSTEST.LOAD.HOSDR130,DISP=SHR
 //         DD DSN=&PREF..HOSTEST.LOAD.HOSPR130,DISP=SHR
 //         DD DSN=&LIB,DISP=SHR
 //SYSPRINT DD SYSOUT=A
 //PRTFILE  DD SYSOUT=A
 //SYSOUR   DD SYSOUT=A
 //SYSOUT   DD SYSOUT=A
 //SYSUDUMP DD SYSOUT=A
 //BILLFILE DD DISP=OLD,DSN=&PREF..HOSTEST.BILL090
 //MSAFILE  DD DISP=OLD,DSN=&PREF..HOSTEST.MSAH050
 //CBSAFILE DD DISP=OLD,DSN=&PREF..HOSTEST.CBSA130
 //PROVFILE DD DISP=OLD,DSN=&PREF..HOSTEST.PROV130
 //RATEFILE DD DSN=&PREF..HOSTEST.OUT,
 // DISP=(,CATLG,DELETE),UNIT=SYSDA,
 // SPACE=(TRK,(50,5),RLSE),
 // DCB=(RECFM=FB,LRECL=135,BLKSIZE=135)
 // PEND
 //T1       EXEC HOSTEST2,PREF='XX.XXXX'

   ** Note:    Supply your own job card and apply your data center's  standards.

 FIGURE 4.3 - Sample JCL to Execute HOSDR130 VS/COBOL II/COBOL FOR Z/OS.























                                        V-2

1                  HOSPICE CICS PRICER INSTALLATION GUIDE

--------- FIELD LEVEL/NAME ---------- -PICTURE- -NUMBER START     END  LENGTH
                > > > > > START OF Incoming Billing Data Layout < < < < <
HOLD-BILL-DATA                                              1     135     135
  10 HLD-NPI                          X(10)          1      1      10      10
  10 HLD-PROV-NO                      X(6)           2     11      16       6
  10 HLD-FROM-DATE-ALL                GROUP          3     17      24       8
    15 HLD-FROM-CC                    99             4     17      18       2
    15 HLD-FROM-DATE                  GROUP          5     19      24       6
      20 HLD-FROM-YY                  99             6     19      20       2
      20 HLD-FROM-MM                  99             7     21      22       2
      20 HLD-FROM-DD                  99             8     23      24       2
  10 HLD-PROV-MSA-LUGAR               GROUP          9     25      29       5
    15 HLD-PROV-MSA                   X(4)          10     25      28       4
    15 HLD-PROV-LUGAR                 X             11     29      29       1
  10 HLD-PROV-CBSA REDEFINES HLD-PROV-MSA-LUGAR
  10 HLD-PROV-CBSA                    X(5)          12     25      29       5
  10 HLD-BENE-MSA-LUGAR               GROUP         13     30      34       5
    15 HLD-BENE-MSA                   X(4)          14     30      33       4
    15 HLD-BENE-LUGAR                 X             15     34      34       1
  10 HLD-BENE-CBSA REDEFINES HLD-BENE-MSA-LUGAR
  10 HLD-BENE-CBSA                    X(5)          16     30      34       5
  10 HLD-PROV-WAGE-IND                99V9(4)       17     35      40       6
  10 HLD-BENE-WAGE-IND                99V9(4)       18     41      46       6
  10 HLD-GROUP1                       GROUP         19     47      65      19
    15 HLD-REV1                       X(4)          20     47      50       4
    15 HLD-UNITS1                     9(7)          21     51      57       7
    15 HLD-THEIR-PAY-CHG1             9(6)V99       22     58      65       8
  10 HLD-GROUP2                       GROUP         23     66      84      19
    15 HLD-REV2                       X(4)          24     66      69       4
    15 HLD-UNITS2                     9(7)          25     70      76       7
    15 HLD-THEIR-PAY-CHG2             9(6)V99       26     77      84       8
  10 HLD-GROUP3                       GROUP         27     85     103      19
    15 HLD-REV3                       X(4)          28     85      88       4
    15 HLD-UNITS3                     9(7)          29     89      95       7
    15 HLD-THEIR-PAY-CHG3             9(6)V99       30     96     103       8
  10 HLD-GROUP4                       GROUP         31    104     122      19
    15 HLD-REV4                       X(4)          32    104     107       4
    15 HLD-UNITS4                     9(7)          33    108     114       7
    15 HLD-THEIR-PAY-CHG4             9(6)V99       34    115     122       8
  10 HLD-RETURNED-DATA                GROUP         35    123     135      13
    15 HLD-PAY-AMT                    9(6)V99       36    123     130       8
    15 HLD-RTC                        XX            37    131     132       2
    15 FILLER                         XXX           38    133     135       3

                                                 FIELD
--------- FIELD LEVEL/NAME ---------- -PICTURE- -NUMBER START     END  LENGTH
                > > > > > START OF Provider Data Table < < < < <
 PROV-TABLE                                                  1  192000  192000
   2 PROV-ENTRIES(1) OCCURS 2400 TIMES
                                       GROUP          1      1      80      80
     10 PROV-DATA1(1)                  GROUP          2      1      80      80
       15 PROV-NPI10(1)                GROUP          3      1      10      10
         20 PROV-NPI8(1)               X(8)           4      1       8       8
         20 PROV-NPI-FIL(1)            XX             5      9      10       2
       15 PROV-NO(1)                   X(6)           6     11      16       6
       15 PROV-EFF-DATE(1)             X(8)           7     17      24       8
       15 FILLER(1)                    X(56)          8     25      80      56


                                             V-3

1  HOSPICE CICS PRICER INSTALLATION GUIDE

                                                 FIELD
--------- FIELD LEVEL/NAME ---------- -PICTURE- -NUMBER START     END  LENGTH
     > > > > > START OF Additional Provider Data Table Layout < < < < <

PROV-DATA-2                                                 1  192000  192000
  2 PROV-ENTRIES2(1) OCCURS 2400 TIMES
                                      GROUP          1      1      80      80
    10 PROV-DATA2(1)                  X(80)          2      1      80      80


                                                 FIELD
--------- FIELD LEVEL/NAME ---------- -PICTURE- -NUMBER START     END  LENGTH
     > > > > > START OF Additional Provider Data Table Layout < < < < <

PROV-DATA-3                                                 1  192000  192000
  2 PROV-ENTRIES3(1) OCCURS 2400 TIMES
                                      GROUP          1      1      80      80
    10 PROV-DATA3(1)                  X(80)          2      1      80      80

                                                 FIELD
--------- FIELD LEVEL/NAME ---------- -PICTURE- -NUMBER START     END  LENGTH
               > > > > > START OF MSA Table Layout  < < < < <
MSA-WI-TABLE                                                1   76000   76000
  5 M-MSA-DATA(1) OCCURS 4000 TIMES
                                      GROUP          1      1      19      19
    10 MSA-MSA-LUGAR(1)               GROUP          2      1       5       5
      15 MSA-MSA(1)                   9(4)           3      1       4       4
      15 MSA-LUGAR(1)                 X              4      5       5       1
    10 MSA-EFFDTE(1)                  X(8)           5      6      13       8
    10 MSA-WAGE-IND(1)                S99V9(4)       6     14      19       6

                                                 FIELD
--------- FIELD LEVEL/NAME ---------- -PICTURE- -NUMBER START     END  LENGTH
               > > > > > START OF CBSA Table Layout < < < < <
CBSA-WI-TABLE                                               1   76000   76000
  5 M-CBSA-DATA(1) OCCURS 4000 TIMES
                                      GROUP          1      1      19      19
    10 M-CBSA(1)                      9(5)           2      1       5       5
    10 M-CBSA-EFFDTE(1)               X(8)           3      6      13       8
    10 M-CBSA-WAGE-IND(1)             S99V9(4)       4     14      19       6


   FIGURE 4.4:        Call List Argument # 2
                      Input Billing Data, Provider Data Table,
                      Additional Provider data tables 1 and 2,
                      CBSA Table Data, and
                      MSA Table Data Sent to HOSDR
                      RETURNS WITH RATE PAYMENT Data in original
                      bill data layout.










                                  V-4

1                  HOSPICE CICS PRICER INSTALLATION GUIDE

  ------------------------------------------------------------------------
 !                              !         !      !         COBOL          !
 !          FIELD               !   LOC   ! SIZE !----------------------  !
 !                              !         !      !   PICTURE  !   USAGE   !
 !==============================!=========!======!============!=========  !
 !                              !         !      !            !           !
 ! NATIONAL PROVIDER            !         !      !            !           !
 !    IDENTIFIER                !  1-10   !  10  ! X(10)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! PROVIDER NUMBER (OSCAR)      !  11-16  !  6   ! X(06)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! FROM EFFECTIVE DATE          !  17-24  !  8   ! X(08)      ! CCYYMMDD  !
 !------------------------------!---------!------!------------!-----------!

        NOTE ***   REDEFINED FIELD
 !------------------ ------------------------------------------------------!
 ! PROVIDER MSA CODE            !  25-28  !  4   ! X(04)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! PROVIDER LUGAR               !  29     !  1   ! X(01)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 !  NOTE ****PROVIDERS CBSA CODE REDEFINES POSITIONS 25-29                !
 !                                                                        !
 ! PROVIDER CBSA CODE           !  25-29  !  5   ! X(05)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!

        NOTE ***   REDEFINED FIELD
 !------------------------------------------------------------------------
 ! BENE'S MSA CODE              !  30-33  !  4   ! X(04)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! BENE'S LUGAR                 !  34     !  1   ! X(01)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 !  NOTE ****BENES CBSA CODE REDEFINES POSITIONS 30-34                   !

 !                                                                        !
 ! BENE'S CBSA CODE             !  30-34  !  5   ! X(05)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!


          CONTINUE NEXT PAGE









                                     V-5

1                  HOSPICE CICS PRICER INSTALLATION GUIDE

  ------------------------------------------------------------------------
 !                              !         !      !         COBOL          !
 !          FIELD               !   LOC   ! SIZE !----------------------  !
 !                              !         !      !   PICTURE  !   USAGE   !
 !==============================!=========!======!============!===========!
 ! PROVIDER'S WAGE INDEX        !  35-40  !  6   ! 9(02)V9(04)! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! BENE'S WAGE INDEX            !  41-46  !  6   ! 9(02)V9(04)! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP1 -- REVENUE CODE       !  47-50  !  4   ! X(04)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP1 -- UNITS              !  51-57  !  7   ! 9(07)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP1 -- THEIR PAYMENT      !  58-65  !  8   ! 9(06)V99   ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP2 -- REVENUE CODE       !  66-69  !  4   ! X(04)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP2 -- UNITS              !  70-76  !  7   ! 9(07)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP2 -- THEIR PAYMENT      !  77-84  !  8   ! 9(06)V99   ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP3 -- REVENUE CODE       !  85-88  !  4   ! X(04)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP3 -- UNITS              !  89-95  !  7   ! 9(07)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP3 -- THEIR PAYMENT      !  96-103 !  8   ! 9(06)V99   ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP4 -- REVENUE CODE       !  104-107!  4   ! X(04)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP4 -- UNITS              !  108-114!  7   ! 9(07)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! GROUP4 -- THEIR PAYMENT      !  115-122!  8   ! 9(06)V99   ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!
 ! RETURNED DATA FROM HOSPR130  !  123-130!  8   ! 9(06)V99   ! DISPLAY   !
 !    PAYMENT AMOUNT            !         !      !            !           !
 !------------------------------!---------!------!------------!-----------!
 ! RETURNED DATA FROM HOSPR130  !  131-132!  2   ! X(02)      ! DISPLAY   !
 !    RETURN CODE               !         !      !            !           !
 !------------------------------!---------!------!------------!-----------!
 ! FILLER                       !  133-135!  3   ! X(03)      ! DISPLAY   !
 !------------------------------!---------!------!------------!-----------!

   FIGURE 4.5:        RATE FILE OUTPUT TEST HOSPICE FORMAT







                                      V-6

