Electronic Visit Verification General Stakeholder Meeting August - - PowerPoint PPT Presentation

Electronic Visit Verification

General Stakeholder Meeting

August 18, 2020

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Our Mission

Improving health care access and

• utcomes for the people we serve

while demonstrating sound stewardship of financial resources

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WELCOME Stakeholders

• HCPF Introductions
• Housekeeping

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Meeting Purpose

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 Project Updates
• Provide a platform to gather stakeholder

feedback

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Meeting Guidelines

We ask that you:

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

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Agenda

Introductions Brief Overview of EVV EVV Mandate Department EVV Memos Program Updates Sandata Call Center Report Department Data Analytics Resources Training Support Stakeholder Engagement Open Forum

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Overview

• f EVV

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What is EVV?

• 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

• Section 12006 of the 21st Century Cures Act

requires all state Medicaid agencies implement an EVV solution

• States 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

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State EVV Solution Technologies

Mobile Application Telephony Provider Web Portal

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What must EVV Capture?

TYPE OF SERVICE PERFORMED INDIVIDUAL RECEIVING THE SERVICE DATE OF THE SERVICE LOCATION OF SERVICE DELIVERY INDIVIDUAL PROVIDING THE SERVICE TIME THE SERVICE BEGINS AND ENDS

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• Personal Care
• Pediatric Personal Care
• Home Health: RN, LPN, CNA, PT, OT, SLP
• Private Duty Nursing
• Hospice
• Homemaker
• Respite (provided in the home or community)
• Consumer Directed Attendant Support Services

(CDASS)

• In-Home Support Services (IHSS)
• Independent Living Skills Training (ILST)
• Life Skills Training
• Physical Therapy (provided in the home)
• Occupational Therapy (provided in the home)
• Speech Therapy (provided in the home)
• Behavioral Therapies (provided in the home or

community)

• Pediatric Behavioral Health
• Youth Day
• Durable Medical Equipment (select services)

Which Services Require EVV?*

*Subject to change

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

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Service Types Groupings

Service Location

• EVV services happen in the home and in

the community.

• EVV does not disrupt this flexibility of

service location.

• Facility-based services are exempt from

EVV unless otherwise noted.

• Capture location where the service occurs

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State EVV Model: Hybrid

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

vendor must ensure that their system is configured to Colorado EVV rules and requirements.

• Provider Choice Systems must connect to

the Data Aggregator

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Questions

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EVV Mandate

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• EVV is required by section 8.001 of the Colorado Code of Regulation
• 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 subject to

Compliance Monitoring, Request for Written Response, or Overpayment Recovery

• On January 1, 2021, claims without corresponding EVV will deny

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Colorado EVV Mandate

• 9/18/19: Good Faith Effort Exemption request approved by CMS
• 10/1/2019: State EVV Solution and Data Aggregator went live
• 10/1/2019 – 8/2/2020: Soft-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

Colorado EVV Implementation Timeline

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• The State EVV Solution and Data Aggregator is live and available for use
• Opportunity for caregivers to practice EVV collection and for members to become

accustomed to EVV

• Opportunity for providers to use EVV before claims integration. Claims will continue

to pay and EVV errors will appear on Remittance Advice (EOB 3054) without consequence.

• Implementing early helps everyone by helping the Department identify and develop

supplemental training materials

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Implementation Reminders

Department EVV Memos

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Department Memos

• Department memos are available
• nline*
• All salient points are discussed in

stakeholder meetings; memos may be used as references and official guidance from the Department

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*Direct link to Department Memos

Memo PM 20-007

Electronic Visit Verification (EVV) Address Confidentiality Program (ACP) Guidance

• Policy Memo regarding State

Statute (ACP)*

• Supersedes previous ACP EVV

Guidance (PM 20-001)

• How providers and caregivers can

use EVV while protecting ACP participants

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*Direct link to EVV & ACP Memo

Memo PM 20-006

Durable Medical Equipment Electronic Visit Verification (EVV) Exemption

• Policy Memo regarding Code of

Colorado Regulations inclusion of DME in the EVV program*

• DME removal from the EVV program
• Functionally removed, removal

from rule forthcoming

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*Direct link to EVV & DME Memo

Memo OM 20-079

Electronic Visit Verification (EVV) Compliance Timeline

• Operational Memo(1) clarifying Code
• f Colorado Regulations EVV

compliance timeline(2)

• Supersedes previous EVV Mandate

Timeline (OM 20-012)

• Discusses the stages of the EVV

compliance timeline and multiple supports for EVV users

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(1)Direct link to EVV Memo (2)Direct link to rule

• Beginning August 3, 2020, providers not using EVV must

submit a written plan to the Department outlining their intent to utilize EVV and when compliance is expected.

• Provider Expectations:
• Training must be completed immediately
• Client and employee data must be entered immediately
• Providers must make an earnest effort to collect EVV data

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First Compliance Timeline Stage: Compliance Monitoring

• Beginning October 1, 2020, in addition to the August 3, 2020

enforcement requirements, all claims subject to EVV requirements will pay initially, but paid claims that do not have valid matching EVV records may be subject to Department review and recoupment as Over-Payment Recovery.

• Provider Expectations:
• Improve the percentage of non-compliant claims billed
• Establish communication with the Department regarding any issues impeding

implementation

• Respond to Department guidance appropriately

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Second Compliance Timeline Stage: Over-Payment Review

• Beginning January 1, 2021, in addition to the October 1, 2020,

enforcement, all claims submitted to the Department that require EVV records must be matched to valid EVV records to pay

• January 1, 2021 also marks the beginning of tying EVV compliance

directly to the Colorado Medicaid Provider Agreement

• Provider Expectations:
• All EVV records are collected appropriately and transition into claim integration is as

smooth as possible

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Third Compliance Timeline Stage: Pre-Payment Claim Adjudication

• State EVV Solution interim option
• Switching to a different EVV vendor
• CDASS vendor switching
• Implementation coaching (As discussed in support pathways)

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Compliance Timeline Memo: User Supports

Questions

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Program Updates

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• Live-in Caregivers may be exempt from EVV
• Provider agencies may choose to collect EVV from Live-in Caregivers
• Live-in Caregiver Attestation Forms must be submitted to the provider

agency or FMS vendor

• At this time, the Department only collects Live-in Caregiver Attestation

Forms for Part C: Extenuating Circumstances

• Do not send Part A or Part B forms to the Department
• Live-in Caregiver Attestation Forms must be updated annually or when

information becomes outdated

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Live-in Caregiver Touchbase

• Durable Medical Equipment (DME) has been removed from the EVV

program (as discussed in the Memo portion)

• Hospice Inpatient care no longer requires EVV records
• DME and Hospice will still be visible in the mobile application and

system specifications

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Unused EVV Types of Service

• Due to the unique federally-mandated payment structure for Hospice

services, Hospice services are exempt from Pre-Payment Claim

• Adjudication. Hospice services are subject to Compliance Monitoring

and Over-Payment Review only

• When EVV is possible for in-home Hospice, it is still required

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Hospice

Questions

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Sandata Call Center Report

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Sandata Call Center

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Phone: 855-871-8780 Email: COCustomerCare@Sandata.com

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Total Incoming Calls

Percent of Calls Captured

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Call Times: What To Expect

Wait Time for a Call Representative Time With a Call Representative 24.20 Seconds 10.50 Minutes

Top 5 Call-Center Questions

• 1. Creating a Client
• 2. Creating an Employee
• 3. Visit Maintenance – Exceptions
• 4. Security – EVV Password Reset*
• 5. Visit Maintenance – Review Visit

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* Requires assistance from Sandata

Available on the Department’s EVV website

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Clients, Employees, & Visit Maintenance

Available on the Department’s EVV website under State Solution Page

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Clients, Employees, & Visit Maintenance

Questions

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EVV Department Analytics

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Cumulative Percent of Providers Billing EVV Services Who Utilized an EVV System At least Once

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Percent of EVV Claim Lines Without an EVV Error Each Week

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Count and Percentage Breakdown of Billing Providers

36- HCBS 25- Practitioner 10- Home Health 14- Supply 48- Rehab 50- Hospice 27- Speech Thrpy 83- Behavr Thrpy 17- Physical Thrpy 28- Occptnl Thrpy 16- Clinic 09- Pharmacy 60- Personal Care 84- Behavr Thrpy

331 Utilizing Providers

1,181 Non-Utilizing Providers

Questions

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Resources

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EVV Website

Timeline

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www.colorado.gov/hcpf/evv

EVV Website

Resources

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www.colorado.gov/hcpf/evv

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Resources

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Resources

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Resources

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Resources

Training

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Required Training

• Billing providers must complete training to access

the State EVV Solution OR the Provider Choice Date aggregator.

• Training is online, self-paced, and available 24/7.
• First person to complete training for an agency

will be sent the agency’s access credentials within 48 hours.

• Providers agencies may contact the Sandata Help

Desk for access credentials after completing training.

• Providers with multiple enrollments may contact

the Sandata Help Desk to bypass multiple trainings.

• Training links can be found on the Department’s

EVV website.

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Available on the Department’s EVV website

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Accessing Training

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Provider Choice Training

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State Solution Training

Support

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EVV Support Pathways

Pathway Method Purpose Prepare Before Contacting Expected Initial Response Time EVV Help Desk 1-855-871-8780 COCustomerCare @sandata.com Using State EVV Solution, interfacing Provider Choice Systems, Sandata trainings, EVV accounts Nothing needed Phone: As soon as connected Email: within two business days DXC (Billing) Help Desk 1-844-235-2387 Provider billing or claims processing questions Nothing needed As soon as connected HCPF EVV Inbox EVV@state.co.us

• Dept. approval of Live-in

Caregiver exemption, Policy and Program answers,

Escalations from other support methods

Live-in Caregiver Documentation for review, Help Desk

documentation

(Call number, who you talked to, etc.) Within a week

HCPF Inbox

EVV@state.co. us

HCPF Listening Sessions

https://cohcpf.ad

• beconnect.com/

evvofficehours/

Phone: 1-877-820- 7831 Participant code: 982280#

DXC (Billing) Help Desk

Phone: 1-844-235- 2387

EVV Help Desk

Phone: 1-855-871- 8780 Email:

COCustomerCare @sandata.com

Provider Choice Interface

Phone: 1-844-289- 4246 Email:

COAltEVV @sandata.com

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EVV Support Pathways

• Informal setting for questions about EVV implementation
• Open for all to listen to questions and responses
• No new policy or processes
• “First and third Thursday” of each month
• Next session on Thursday, August 20, 2020

➢ Available on the Department’s EVV website under Stakeholder Information

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EVV Listening Sessions

Stakeholder Engagement

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EVV Recurring Meetings

• Third Tuesday of the month
• 10:30 am - 12:00 pm
• Next Meeting: September 22

General Stakeholder

• Last Tuesday of the month
• 10:30 am - 12:00 pm
• Next Meeting: August 25

Member and Caregiver

• First Thursday of the month –AND- the Thursdays

following the EVV General Stakeholder Meeting

• Next Meeting: August 20

Listening Sessions

Email evv@state.co.us for a calendar invite

Contact Information

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EVV@state.co.us www.colorado.gov/hcpf/evv

Thank you!

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