Electronic Visit Verification General Stakeholder Meeting June 16, 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 Code of Regulation Update Caregiver S upplemental Materials Agenda Telemedicine in EVV 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
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 9
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 10
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 11
• EVV services happen in the home and in the community. Service • EVV does not disrupt this flexibility of service location. Location • Facility-based services are exempt from EVV unless otherwise noted. 12 12
Colorado selected a vendor that will provide EVV solutions, while also allowing providers to use alternative/ existing EVV systems if they meet state specifications: Providers choosing to use an alternate State EVV vendor must ensure that their system is configured to Colorado EVV rules and Model: requirements. Hybrid Provider Choice S ystems must connect to the Data Aggregator Training is required for S tate EVV S olution and Provider Choice EVV 13
State EVV Solution Technologies Mobile Application Telephony Provider Web Portal 14
Questions 15
EVV Implementation Timeline 16 16
Soft-Launch Review • The S tate EVV S olution and Data Aggregator are now 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 17
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. 18
Medical Services Board Update • S takeholder feedback incorporated in-between readings • EVV rule passed Medical S ervices Board on June 12, 2020 • Final rule will post to S ecretary of S tate website in late July First Reading: 5/ 8/ 2020 S econd Reading: 6/ 12/ 2020 Mandate Effective: 8/ 3/ 2020 19
Project Updates 20 20
Caregiver Supplemental Material • Caregiver Guide – Mobile Visit Verification Set -up • Caregiver Guide – Mobile Visit Verification • Caregiver Guide – Telephony Visit Verification • Telephony Visit Verification – Quick Reference Guide • Caregiver Letter – EVV Mandate Details • Available on t he Depart ment ’ s EVV websit e under Resources 21
Caregiver Guide – MVV Setup • For caregiver initial setup of the S tate EVV S olution Mobile Application • Provider Agencies remain the primary resource for caregiver support 22
Caregiver Guide - MVV • For caregivers who use the S tate EVV S olution Mobile Application • Provider Agencies remain the primary resource for caregiver support 23
Caregiver Guide - TVV • For caregivers who use of the S tate EVV S olution Telephony Visit Verification • Provider Agencies remain the primary resource for caregiver support 24
TVV Quick Reference Guide 25
Caregiver EVV Letter • Letter for agencies to provide caregivers explaining the EVV mandate 26
Telemedicine and EVV Updated Guidance 27
Telemedicine Guidance • UPDATES guidance from January 2020 on website • EVV is required for all services normally requiring EVV, including newly expanded to allow Telemedicine (including services that use Place of S ervice 02 and modifier GT) • Location of client must be recorded in EVV record. Alternate location functionality may be needed. 28
Sandata Call Center Report 29
Sandata Call Center Phone: 855-871-8780 Email: COCustomerCare@ S andata.com 30
Total Incoming Calls 31
Percent of Calls Captured Jun-20 32
Call Times: What To Expect Wait Time for a Call Representative Time With a Call Representative 22.35 S econds 10.60 Minutes 33
EVV Department Analytics 34
Expected and Cumulative Percent of Providers Who Utilized an EVV System Expected Percent 72.73% Cumulative Percent 11.74% 35
Utilizing Provider Types 10 Home Health 16 Clinic - Practitioner 17 Physical Therapist Non-Physician 25 Practitioner - Group 27 S peech Therapist 28 Occupational Therapist Home & Community 36 Based S ervices (HCBS ) 48 Rehabilitation Agency 50 Hospice Behavioral Therapy 83 Clinic 36
Billing Provider Types 10 Home Health 11 Case Management Agency 14 S upply 16 Clinic - Practitioner 17 Physical Therapist 25 Non-Physician Practitioner - Group 27 S peech Therapist 28 Occupational Therapist Home & Community Based S ervices 36 (HCBS ) 48 Rehabilitation Agency 50 Hospice 83 Behavioral Therapy Clinic 37
Most Common Visit Exceptions Visits Without In Calls Unknown 5.21% Employees Location Required 5.72% Visit exceptions 21.66% are error flags Missing S ervice 12.55% thrown on a visit that is missing one or more required points of data. Visits Without Out Unmatched Client Calls ID/ Phone 14.25% 20.44% Visits Without Any Calls 20.17% 38
Questions 39
Contact I nformation Lana Eggers EVV@ state.co.us www.colorado.gov/ hcpf/ evv 40
Thank you! 41
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