Alternate EVV Systems Julie Evers Kristy Wathen June 26, 2018. 1 - PowerPoint PPT Presentation

Alternate EVV Systems Julie Evers Kristy Wathen June 26, 2018. 1

What is an Alternate EVV System? • An alternate EVV system is an electronic verification system (EVV) that is used in place of the Sandata system for purposes of satisfying data collection requirements established by the Ohio Department of Medicaid (ODM). • An alternate EVV system must comply with: » Ohio Administrative Code 5160-1-40 » Technical Specifications » ODM Business Requirements • Only agency providers have the option to use an alternate EVV System. 2

Ohio Administrative Code Rule 5160-1-40 3

How Data is Collected • Until January 1, 2019, an alternate EVV system must have at least two methods to collect data. » The primary method must be either telephony of a mobile device that utilizes GPS technology to collect location » Manual visit entry must be an alternative. • Beginning January 1, 2019, have at least three methods to collect data » The primary method must be a mobile device that utilizes GPS technology to collect location » Include at least two alternative methods of data collection » Alternative methods must include manual visit entry 4

Re-approval of Alternate System • ODM can require re-approval of alternate data collection systems • Examples of circumstances that will require re-approval are: » A change in data that must be sent to the aggregator » A failure to comply with alternate system requirements by the providers » A failure to comply with alternate system requirements by the vendor • A provider may be required to use the Sandata system while re-approval is pending. • Costs incurred by the provider for the original approval or a subsequent re-approval are not the responsibility of the state or of Sandata. 5

Business Rules 6

General Requirements • Each user must have a unique identifier. • Administrative users who have access to edit and/or enter data must have unique email addresses that are sent to the aggregator. • Send EVV data to the Sandata aggregator at least daily. » Data submissions must be sent using an interface that has been tested and approved by Sandata. » Data submissions must be sent using the specifications in the Technical Specifications. 7

Visit Exceptions and Edits • Alternate EVV systems must give providers the ability to manually enter and edit visits. » Alternate systems must use the standard list of reason codes in the manual entry and visit edit process. » An audit trail must be maintained for all manual entries and visit edits. » An attestation confirming the presence of supporting documentation for all manual entries and visit edits must be collected. • The provider must use the Sandata aggregator to identify any exceptions that have posted to visits recorded and transmitted. » All exceptions must be cleared before a visit will be used to substantiate a claim during adjudication. 8

Capturing Verification of Service Delivery • Alternate EVV systems must capture verification of the service delivered and the date/time of service delivery. » The alternate EVV system can capture a voice or digital signature. » EXCEPTION: No verification of date, time or service delivery is required for services provided through a waiver administered by DODD. • Alternate EVV systems must send an indicator showing that the individual verification is available to the aggregator as part of the visit record. • GPS coordinates are not an acceptable substitute for the voice and/or digital signatures. 9

Certification Process 10

Certification Process 11

Things to Consider • Do your research. It is the provider’s responsibility to make sure an alternate EVV system satisfies all ODM requirements. • Each provider must choose to use either an alternate EVV system or the Sandata system. You can’t do both. • The provider – NOT THE VENDOR – must initiate the certification process. • ODM can require recertification as the agency deems necessary. » New data elements » Compliance issues related to the provider » Compliance issues related to the vendor 12

For Additional Information • ODM Electronic Visit Verification Webpage http://medicaid.ohio.gov/INITIATIVES/Electronic-Visit- Verification • EVV Mailbox (EVV@Medicaid.Ohio.gov) • EVV Policy (EVVPolicy@Medicaid.Ohio.gov) 13

Questions 14