Elect ron onic Visit Verificat ion on W EL ELCOME E ! HCPF - - PowerPoint PPT Presentation

Elect ron

• nic Visit Verificat ion
• n

W EL ELCOME E !

• HCPF Introductions
• Restroom location
• Sign in sheet

Agenda

Introductions Updates EVV S ystem Overview EVV Policy Attentions Top 5 F AQ’s Open Forum Q&A

Meet eet ing Guidel elines es

We ask that you:

• Mind E-manners
• Identify yourself when speaking
• Share the air
• Listen for understanding
• Stay solution and scope focused

Meet eet ing Purpose se

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 State Plan and Waivers.

And specifically to:

• Review EVV, the legislative mandate, and the scope of implementation
• Discuss EVV Implementation Process
• Provide EVV timeline updates
• Address stakeholder concerns
• Provide a platform to gather stakeholder feedback

W hat is EVV?

• Electronic visit verification (EVV) is a technology solution

which electronically verifies that home and community- based services are actually delivered to people needing those services by documenting the precise time service begins and ends.

• Includes multiple point-of-care visit verification

technologies, such as telephonic, mobile and fixed visit verification inputs

W hy y is EVV required?

• Section 12006 of the 21st Century Cures Act requires all

states implement an Electronic Visit Verification (EVV) solution to manage their Personal Care services by January 1, 2019, and for all Home Health services by January 1, 2023.

• States that do not implement EVV will incur a reduction of

Federal funding.

21 st

st Cen

ent ury Cures es Act

The Act does not:

• Limit the services provided
• Limit provider selection
• Constrain individuals choice of caregiver
• Impede the way care is delivered
• In any way establish an employer-employee relationship

W hat m ust EVV verify? y?

Type of service performed I ndividual receiving the service Date of the service Location of service delivery I ndividual providing the service Time the service begins and ends

St at e E EVV M Model

• Colorado selected a vendor

that will provide EVV solutions, while allowing all providers to choose alternative/ existing EVV systems, if they meet state specifications

Hybrid Model

Benefits of Hybrid Model

• Providers have the flexibility to select their own EVV

system

• Providers have a no cost solution through the state if

they so choose

• Providers have centralized platform to use without

running their own procurements, alleviating burden if they choose

• Centralized platform facilitates linking EVV with MMIS

claims data

W hich Ser ervices R es Req equire E e EVV?*

• Personal Care
• Home Health
• Private Duty Nursing
• Hospice
• Homemaker
• In-Home Respite
• Consumer Directed Attendant Support Services(CDASS)
• In-Home Support Services (IHSS)
• Independent Living Skills Training (ILST)
• Specialized Medical Equipment and Supplies
• Outpatient Physical Therapy, Occupational Therapy, Speech Therapy (provided in the home)
• Managed Care and Fee-For-Service Delivery Options

*Subject to CMS Guidance

Colorado E

• EVV Technol
• log
• gies
• Services can be delivered in a variety of settings
• It is accessible with ADA technology
• Can work in rural/frontier areas and does not need Wi-Fi to collect the data
• GPS location is not viewable on screen (GPS not required)
• Web portal feature to provide flexibility for devices to input data

Mobile App

• Landline can be used
• It is accessible with ADA technology
• Not internet or data dependent
• Any phone may be used if landline is not available

Telephony

Ben enef efit s o s of EVV

• Improving accuracy of service delivery
• Verifying visits on a real-time basis
• Automating missed visit alerts to more quickly implement back-up

plans

• Validating hours of work
• Eliminating billing data entry mistakes
• Reducing costs related to paper billing and payroll

Dep epart m ent I m plem em en ent at ion Updat es es

Contract and IAPD has been approved by CMS Contract with Sandata will be executed in the next few weeks

• Program Business rules are currently in a drafting

phase

• Department service and provider rules

Provider Survey

“ Soft ” Launc unch h

• In this type of implementation, the state requires that EVV be submitted in

accordance with a claim, but does not initially deny payment based upon a lack

• f data or incorrect use of EVV.
• Instead, the state agency uses the information and errors to provide additional

technical assistance and training targeted to key problem areas and providers that are struggling with the technology.

• The soft launch period will give provider entities enough time to acclimate to the

new requirements. Once the soft launch period is over, the EVV system(s) will begin denying claims if the system is not properly used.

EVV I m ple lem ent at at io ion T Tim im elin line*

Phase 1 7/1/2018 -1/1/2019

• Develop business

rules

• Execute contract
• Start pilot phase
• Develop

Department Rules

• Start training
• Launch Aggregator
• UAT Testing
• Launch BIDM

interface Phase 2 1/1/2019-6/28/2019

• Collect stakeholder

input on scheduling module

• Start Third Party

System Verification

• Identify claims that

do NOT have EVV record

• Outreach to providers

with paid claims, but without corresponding EVV

• Identify Training

Gaps

Phase 3 7/1/2019-12/31/2019

• Launch the EVV

Scheduling Module

• Launch Consumer

Directed Attendant Support Services (CDASS) Suite

• interChange begins

editing claims

• Automate billing to

approved EVV

• interChange begins

denying claims that do NOT have a corresponding EVV

* Dates and times will be solidified upon contract execution

How Does es t he e EVV sy syst st em em w ork?

• What are the options if a client does not have a

phone, data, or wi-fi?

• How can GPS be turned off?
• Do all members need to verify?
• Do all members need to have a device ?

Top 3 ADA Compliance Concerns Addressed

Concern Compliance Members with visual impairments will not be able to use the EVV system. All EVV S ystem features and functionality are available via assistive technology Members with limited mobility will not be able to sign to verify the services they received. Voice-Recorded S ignature Verification; available both in Mobile Application and Telephony functions Members who may want to verify using the Telephony

• ption will not be able to due

to hearing impairment s. S andata’s telephony offering has a standard non-acoustic connection can be utilized as with any telephony.

Compliance Clarification from Sandata:

FAQ and Fact Sheets will soon be released to address details extracted from S andata’ s Voluntary Product Accessibility Templates (VPATs) that demonstrate how the EVV system will be ADA compliant and how it is able to meet the needs of stakeholders with varying abilities.

Policy Considerat rat ion

• ns

S andata system app will turn off the use

• f microphone and

photos during the verification process 1.The system will not have requirements for preset locations or times 1.The system needs to allow for multiple service delivery locations in a single visit 1.The system allows adequate time for family caregivers to confirm services

Top Fi Five FA FAQ

If the delay bills are passed how does that impact the CO implementation? Will CO apply for an extension ? When will certification information for 3rd party vendors be released? How has CMS defined a good faith effort? How can I get involved in the EVV stakeholder process?

Nex ext S St ep eps

• Develop Business Rules with Sandata
• Finalize a training plan and pilot phase
• Monitor the Federal delay bills, H.R.6042 and S.2897, which

request a delay in implementation for up to 1 year

• Continue to seek CMS guidance on services required under EVV
• Develop new FAQ’s for stakeholders around Participant Directed,

System Design, and Privacy

• Meetings are updated on EVV website

Your Feed eedback M Mat t er ers

Stakeholder Questions, Concerns and Recommendations

Con

• nt ac

act

Lana Eggers & Danielle Walker EVV@state.co.us