EVV Stakeholder Advisory Group January 15, 2020 1 Good Faith - PowerPoint PPT Presentation

EVV Stakeholder Advisory Group January 15, 2020 1

Good Faith Exemption 2

Good Faith Exemption • The Cures Act requires state Medicaid programs to implement EVV for all personal care by January 1, 2020. • State Medicaid programs can request a 1 year extension by submitting a Good Faith Exemption Request. States must demonstrate a good faith effort to meet the original statutory deadline • Ohio submitted a Good Faith Exemption request in October 2019 and received approval in November 2019. » EVV must be implemented for all personal care by January 1, 2021 to maintain federal funding levels. » Planned Phase 3 work and timeline will meet this deadline 3

Alternate System Demonstration 4

Alternate System Demonstration Requirement • ODM implemented an alternate system demonstration requirement on October 16, 2019. • The demonstration requirement applies to all alternate system vendor combinations. • The demonstration goes through the Demonstration Checklist. » All items on the checklist must be successfully completed for the provider to satisfy the demonstration requirement. 5

Demonstration Activity • 42 Demonstrations Have been scheduled to date. » 18 demonstrations have been completed » 5 vendors have successfully completed the demonstration requirement. • Available demonstration dates » 4 available dates in February » 8 available dates in March » 6 available dates in April 6

Common Issues Identified In Demonstrations • The vendor must be able to capture at least 3 addresses for each individual receiving services. • The vendor must appropriately generate standard exceptions and show the process for clearing the exceptions. » If an exception cannot occur, the vendor must show ODM that an exception cannot occur. • All manual data entries and edits must include an attestation asserting that supporting documentation is available. » Text fields are not an appropriate solution unless the vendor can show an automated way the test field is used to populate the record sent to the aggregator. • All data should be sent to the Sandata aggregator within 24 hours of capture. » It is not appropriate to hold visits until they are “complete.” 7

Production Credentials and the Demonstration Requirement • A provider/vendor combination that requested testing credentials on or before October 16, 2019 can receive production credentials when the Sandata portion of the certification process is complete. • A provider/vendor combination that requested testing credentials after October 16, 2019 must complete both the demonstration requirement and the Sandata portion of the certification process before receiving production credentials. • Any provider/vendor combination that fails to complete both the demonstration requirement and the Sandata portion of the process before July 1, 2020 will be required to transition to Sandata until their alternate vendor has completed all certification requirements. 8

Device Swap 9

Technology Changes with Apple and Google • With recent updates to Apple and Google IOS platforms, the version of AirWatch needs updated on some of the LG devices currently in use and can not be done remotely. • AirWatch is a program installed on ODM provisioned devices that monitors the health and functions of the device. It sends new releases to the Sandata Mobile Connect (SMC) app on the device when available. 10

Device Maintenance Swap • Over the next 4 months, we will begin a Maintenance Swap effort for only certain LG models. • Maintenance Swap: to exchange device with replacement devices with updated AirWatch software. » About 3,200 providers who have the affected LG models in individual’s homes will receive an email soon about the swap. This will include details on eTRAC status changes. • Please note: There is NO additional action for providers to take. Providers can continue to use the old devices until the replacement one is received in the individual’s home. Providers will be able to view the status of the device in eTrac. Providers can help to answer questions from their individuals. • Device Recovery Effort: to recoup devices not in use for 6 months 11

How the Maintenance Swap will work • The individual will receive a detailed letter explaining this swap via USPS approximately 1 week before their replacement device will arrive. • The individual will receive a package with a replacement device and a return envelope to send back the old device. The individual will drop the old device in the return envelope and seal it. • A pre-paid envelope will be sent to return the old device. • The sealed envelope can be placed in an outgoing mail box, given to a US Mail carrier, placed in a blue USPS box or Fed Ex drop box/location. Please note: UPS will not accept this envelope. 12

DODD Update 13

Educating providers using EVV Informational Report • In mid-October, DODD began including a report containing Electronic Visit Verification (EVV) data in providers’ weekly billing reports. » The report shows only service dates when there were not enough EVV units logged to support claims billed by the provider. • Call center staff provided education to providers about EVV • County boards have summary reports for providers delivering services in their county » Counties are using the reports to engage providers in their counties 14

DODD Providers using EVV 4000 3500 3000 1528 1484 2500 1415 1545 1460 1390 1413 1389 1446 1366 1507 1494 1578 1470 1407 1584 1486 1582 1584 1594 1183 2000 1565 1500 998 939 899 876 914 871 875 899 935 858 854 877 862 923 871 823 773 807 834 752 1000 694 650 641 500 870 850 853 829 822 818 829 797 803 765 755 744 718 728 703 695 689 688 664 642 658 532 81 213 0 Red- no EVV validation; Yellow- some EVV validation, Green- 100% EVV validation 15

DODD Claims Requiring EVV 80,000 70,000 60,000 50,000 38128 37705 31265 32778 32333 30593 30385 33377 35770 34504 36485 35830 29057 27807 40,000 32125 34081 27435 31630 34055 30401 28978 30,000 4396 4134 4770 4304 4634 4253 3963 3950 4700 3977 3667 3803 21731 3957 4442 5461 20,000 3897 10741 9765 7349 5834 5254 22517 19731 20872 18135 20420 22334 22990 23280 24624 23439 24747 26340 23604 21750 26102 10,000 3356 18233 11305 12960 13355 14273 13588 8227 1868 205 0 573 Red- no EVV validation; Yellow- some EVV validation, Green- 100% EVV validation 16

January Outreach – Phase 2 Providers 17

Payer Outreach to Providers not using EVV • All Payers will be sending letters to providers starting the week of 1/21 to those providers who are not logging EVV visits. • Some providers may receive multiple letters if they provide services under multiple payers. » For example, if a provider has ODM, DODD and 1 MCO for EVV services, they will receive 3 of the same letters. 18

Phase 3 Overview 19

Phase 3 Timeline • 1/8/2018 Phase 1 • 8/5/2019 Phase 2 • Fall 2020 Phase 3 provider training will begin » providers may begin using EVV upon completion of training • 01/01/2021 Phase 3 providers are required to use EVV. • Edits will post to claims and claims will not be denied until a date TBD. 20

What Services are included in Phase 3? • Participant Directed Aide Services » MyCare Ohio » ODA » DODD » Ohio Home Care Waiver (once implemented) • Home Health Therapies » Physical Therapy (G0151) » Occupational Therapy (G0152) » Speech Therapy (G0153) 21

Phase 3 Training • New providers will have access to the full EVV training that will include the new services • Existing providers already using EVV will receive bridge training on the EVV system, with a focus on the new functionality • Focused training for the Participant-Directed Program 22

Participant Directed Services and EVV 23

Goals for Implementing EVV for Participant Directed Services • Comply with the 21 st Century Cures Act. • Respect the individual’s role in managing their services without adding unnecessary complexity. • Consistent across programs and payers • Align with exiting processes and policies in programs implementing participant directed services. 24

Considerations in Developing Proposed Approach • Ohio Medicaid has multiple waivers with participant directed services. » Multiple program designs » Two Financial Management Service (FMS) Entities » Some providers work in both participant directed and traditional delivery models and/or in multiple systems. • Existing processes with the FMS entities give individuals the authority and ability to manage their services. • Feedback from Phases 1 and 2 » Some users reported that using the system could be challenging. » Consistency across payers and programs is important. 25

Proposed Approach • Maintain FMS systems and policies that support individuals using participant directed services • FMS entities will be able to view visit data and can share information with individuals managing those services. • Providers of participant directed services will use EVV in the same way Phase 1 and Phase 2 providers use EVV. » Enter individuals receiving services (clients) » Enter employee information (if an agency provider) » Log visits » Clear exceptions 26