Electronic Visit Verification General Stakeholder Meeting July 21, - PowerPoint PPT Presentation

Electronic Visit Verification General Stakeholder Meeting July 21, 2020 1

Our Mission Improving health care access and outcomes for the people we serve while demonstrating sound stewardship of financial resources 2

WELCOME Stakeholders • HCPF Introductions • Housekeeping 3

The purpose of this meeting is to engage providers, members, and other stakeholders as the Department works to implement EVV for community based services offered through both the S tate Plan and Waivers. And specifically to: Meeting • Review EVV , the legislative mandate, and Purpose the scope of implementation • Discuss EVV Proj ect Updates • Provide a platform to gather stakeholder feedback 4 4

We ask that you: • Mind E-manners • Identify yourself when speaking Meeting Guidelines • S hare the air • Listen for understanding • S tay solution and scope focused 5 5

Introductions Brief Overview of EVV Implementation Timeline Mandate Readiness Resources and S upport Agenda Proj ect Updates S andata Call Center Report Department Data Analytics Open Forum 6

Overview of EVV 7

• Electronic Visit Verification (EVV) is a technology solution which verifies information through mobile application, telephony, or web-based portal • EVV is used to ensure that home or community- based services are delivered to people needing those services by documenting the precise time service begins and ends What is • S ection 12006 of the 21st Century Cures Act EVV? requires all state Medicaid agencies implement an EVV solution • S tates that do not implement EVV will incur a reduction of Federal funding • The Department will implement and mandate EVV for all Colorado required services on August 3, 2020 8

State EVV Solution Technologies Mobile Application Telephony Provider Web Portal 9

TYPE OF SERVICE I NDI VI DUAL DATE OF THE RECEI VI NG THE PERFORMED SERVICE What must SERVICE EVV Capture? LOCATI ON OF I NDI VI DUAL TI ME THE SERVICE PROVI DI NG THE SERVICE DELIVERY BEGINS AND ENDS SERVICE 10

Which Services Require EVV?* • • Personal Care Independent Living S kills Training (ILS T) • • Pediatric Personal Care Life S kills Training • • Home Health: RN, LPN, CNA, PT, OT, S LP Physical Therapy (provided in the home) • • Private Duty Nursing Occupational Therapy (provided in the home) • • Hospice S peech Therapy (provided in the home) • • Homemaker Behavioral Therapies (provided in the home or community) • Respite (provided in the home or community) • Pediatric Behavioral Health • Consumer Directed Attendant S upport S ervices • (CDAS S ) Youth Day • • In-Home S upport S ervices (IHS S ) Durable Medical Equipment (select services) *Subject to change 11

Service Types Groupings Consumer Directed Consumer Directed Behavioral Attendant Support Durable Medical Home Health – Home Health – Attendant Support Therapies Services – SLS Equipment Certified Nurse Aide Nursing Services Health Maintenance Home Health – Home Health – Home Health – Occupational Speech/Language Homemaker Hospice - In Home Hospice - Inpatient Physical Therapy Therapy Therapy Independent Living Skills Training In-Home Support Occupational Pediatric Behavioral Pediatric Personal Personal Care and Services Therapy Therapies Care Life Skills Training Private Duty Respite and Youth Physical Therapy Speech Therapy Nursing Day 12

• EVV services happen in the home and in the community. • EVV does not disrupt this flexibility of Service service location. Location • Facility-based services are exempt from EVV unless otherwise noted. • Capture location where the service occurs 13 13

Colorado selected a vendor that will provide EVV solutions, while also allowing providers to use alternative/ existing EVV systems if they meet state specifications: State EVV • Providers choosing to use an alternate Model: vendor must ensure that their system is configured to Colorado EVV rules and Hybrid requirements. • Provider Choice S ystems must connect to the Data Aggregator 14

Questions 15

EVV Implementation Timeline 16 16

Colorado EVV Implementation Timeline • 9/ 18/ 19: Good Faith Effort Exemption request approved by CMS • 10/ 1/ 2019: S tate EVV S olution and Data Aggregator went live • 10/ 1/ 2019 – 8/ 2/ 2020: S oft-Launch • 8/ 3/ 2020: EVV mandate, providers must use EVV • 10/ 1/ 2020 – 12/ 31/ 2020: Post payment claims review for providers who are not making an earnest effort to use EVV • 1/ 1/ 2021: Prepayment claims review, claims will deny without corresponding EVV 17

Soft-Launch Review • The S tate EVV S olution and Data Aggregator live and available for use • Providers may begin to collect EVV data and transmit to the Department • Opportunity to familiarize providers with EVV prior to claims integration. Claims will continue to pay and EVV errors will appear on Remittance Advice (EOB 3054). • Opportunity for caregivers to practice EVV collection and for members to become accustomed to EVV • Help the Department identify and develop supplemental training materials • The Department strongly encourages providers to use EVV during the S oft-Launch 18

What changes with the EVV Mandate? • EVV will be required by section 8.001 of the Colorado Code of Regulation on August 3, 2020 • The Department will monitor compliance and outreach provider agencies who are not fully utilizing EVV • Providers who are experiencing unavoidable delays should contact the Department • Providers not making a earnest effort to utilize EVV may be subj ect to Compliance Monitoring, Request for Written Response, or Overpayment Recovery • On January 1, 2021, claims without corresponding EVV will deny 19

Mandate Readiness 20

• Billing providers must complete training to access the S tate EVV S olution OR the Provider Choice Date aggregator. • Training is online, self-paced, and available now. • First person to complete training for an agency will be sent the agency’s access credentials within 48 hours. Required • Providers agencies may contact the S andata Training Help Desk for access credentials after completing training. • Providers with multiple enrollments may contact the S andata Help Desk to bypass multiple trainings. • Training links can be found on the Department’s EVV website. 21

• Live-in Attestation Form • eTRAC R egistration* Top 5 • P rovider P ortal P assword R eset* Call-Center Questions • Create a Client • Unlock an Account* * Requires assist ance from S andata 22 22

Live-in Caregiver Questions Available on t he Depart ment ’ s EVV websit e under Resources 23

Create a Client Available on t he Depart ment ’ s EVV websit e 24

Create a Client Available on t he Depart ment ’ s EVV websit e under S t at e S olut ion Page 25

Implementation Expectations Time Frame • August 3, 2020 to September 30, 2020 Compliance • Training must be completed immediately • Client and employee data must be entered immediately • Providers must make an earnest effort to collect EVV data 26

Implementation Expectations Time Frame • October 1, 2020 – January 1, 2021 Compliance • Improve the percentage of non-compliant claims billed • Establish communication with the Department regarding any issues impeding implementation • Respond to Department guidance appropriately • Overpayment recovery may be sought if no earnest effort is made to collect EVV data 27

EVV Resources and Support 28

Caregiver Resources • Caregiver Letter – EVV Mandate Details • Caregiver Guide – Mobile Visit Verification Set -up • Caregiver Guide – Mobile Visit Verification • Caregiver Guide – Telephony Visit Verification • Telephony Visit Verification – Quick Reference Guide Available on t he Depart ment ’ s EVV websit e under Resources 29

Provider Resources • EVV Live-In Caregiver Attestation Form - Updated July 2020 • EVV Types of Service - Service Code Inclusions - February 2020 Available on t he Depart ment ’ s EVV websit e under Resources 30

EVV Support Pathways Provider DXC (Billing) EVV Help HCPF Inbox Choice Help Desk Desk Interface Phone: Phone: 1-855-871-8780 1-844-289-4246 Phone: EVV@ state.co.us 1-844-235-2387 Email: Email: COCustomerCare COAltEVV @ sandata.com @ sandata.com 31

EVV Support Pathways Prepare Before Expected Initial Pathway Method Purpose Contacting Response Time Phone: As soon as 1-855-871-8780 Using S tate EVV S olution, connected interfacing Provider Choice EVV Help Desk Nothing needed COCustomerCare S ystems, S andata trainings, Email: within two @ sandata.com EVV accounts business days DXC (Billing) Help Provider billing or claims 1-844-235-2387 Nothing needed As soon as connected Desk processing questions Live-in Caregiver Dept. approval of Live-in Documentation for Caregiver exemption, Policy review, Help Desk HCPF EVV Inbox EVV@ state.co.us and Program answers, Within a week documentation (Call Escalations from other number, who you support methods talked to, etc.) 32

Project Updates 33 33