Electronic Visit Verification General Stakeholder Meeting October 15, 2019 1
Our Mission Improving health care access and outcomes for the people we serve while demonstrating sound stewardship of financial resources 2
Welcome Stakeholders • Restroom locations • HCPF Introductions
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: Meeting • Review EVV, the legislative mandate, and the scope of implementation Purpose • Discuss EVV Project Updates • Review current implementation timeline • Provide a platform to gather stakeholder feedback 4
We ask that you: • Mind E-manners Meeting • Identify yourself when speaking Guidelines • Share the air • Listen for understanding • Stay solution and scope focused 5
Introductions Brief Overview of EVV Service Types Required for EVV Agenda Overview Colorado EVV Technologies Good Faith Exemption Request State System & Alternate Vendor Update Training Check-In
• Electronic Visit Verification (EVV) is a technology 7 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 • Section 12006 of the 21st Century Cures Act EVV? requires all state Medicaid agencies implement an EVV solution • States that do not implement EVV will incur a reduction of Federal funding • The Department intends to implement EVV for all Colorado required services in late summer 2020.
What must TYPE OF SERVICE INDIVIDUAL DATE OF THE PERFORMED RECEIVING THE SERVICE SERVICE EVV Capture? LOCATION OF INDIVIDUAL TIME THE SERVICE SERVICE DELIVERY PROVIDING THE BEGINS AND ENDS SERVICE
Which Types of Services Require EVV? EVV Required Select Fee for Services (FFS) State Plan and HCBS Waiver • Services EVV Excepted Per Diem Services, Managed Care, Program for All-Inclusive • Care for the Elderly (PACE), and other Capitated Services 9
Which Services Require EVV?* Personal Care Independent Living Skills Training (ILST) • • Pediatric Personal Care Life Skills Training • • Home Health: RN, LPN, CNA, PT, OT, SLP Physical Therapy (provided in the home) • • Private Duty Nursing Occupational Therapy (provided in the home) • • Hospice Speech 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 Support Services • (CDASS) Youth Day • In-Home Support Services (IHSS) Durable Medical Equipment (requiring in-home • • visit setup) Delayed *Subject to change
Service Types Groupings Consumer Directed Behavioral Attendant Support Home Health Homemaker Hospice Therapies Services Independent Living Pediatric Skills Training In-Home Support Occupational Pediatric Personal Behavioral and Services Therapy Care Therapies Life Skills Training Private Duty Respite and Youth Personal Care Physical Therapy Speech Therapy Nursing Day 11
12 • The Department recognizes that EVV services can happen in the home or in the community. Service • It is essential that EVV does not disrupt this flexibility of service location. Location • Services that happen in a facility or professional building are exempt from EVV. Unless noted otherwise.
Questions or Comments
Key Terminologies Term Meaning State EVV Solution State EVV system available to providers at no cost Provider Choice System EVV system procured, purchased, and used by a provider Alternate Vendor Vendor who manages a provider choice system Data Aggregator Where provider choice systems will submit EVV data to the State Solution
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 State EVV configured to Colorado EVV rules and requirements. Model: Hybrid ✓ Provider Choice Systems must connect to the Data Aggregator ✓ Self-paced aggregator training must be completed prior to connecting to the Data Aggregator
State EVV Solution Overview
Colorado EVV Technologies Mobile Application Telephony Provider Web Portal (Santrax)
Mobile Application: MVV • Mobile Visit Verification (MVV): A GPS enabled mobile application downloaded on a smartphone or tablet • “Bring your own device” method that works on iPhone and Android • GPS Enabled • Captures location when a caregiver clocks-in/clocks-out • No continual location reporting • Direct care workers log-in with unique Sandata ID or email address • Available in English, Spanish, Somali, Russian, Chinese Mandarin, and Arabic Egyptian
Rural Area Considerations • State EVV Solution application will work in rural areas or telephony can be used • MVV will automatically switch to “Disconnected Mode” when smartphone or tablet is not connected to a network • EVV data will be saved for a later transmission when the caregiver logs-in and network connectivity (cellular or wi-fi) is established
Telephony Visit Verification (TVV) • Each provider ID has two toll-free, multi-language numbers • Both numbers are accessible 24 hours a day, 7 days a week • Non-GPS option • Client phone is preferred for TVV • Location captured through ANI technology • Member identified by Sandata Client ID • Direct care workers identified by Sandata ID
Provider Portal • Used for visit maintenance and administrative tasks • Limited capacity for manual entry of EVV data • Used by providers who utilize State EVV Solution • View and verify visits • Address expectations or errors • State enforced manual entry threshold
Good Faith Effort Exemption Request
Colorado EVV Implementation Update Good Faith Effort Exemption request was approved 9/18/19 • Additional time will be used to explore solutions to exempt live-in caregivers • Colorado anticipated EVV mandate will be late summer 2020 • The State EVV Solution and Data Aggregator are now live and available for use • The Department strongly encourages providers to use EVV during the Soft-Launch • 23
Good Faith Effort Request Approved Early Colorado CMS Adoption - Anticipated Mandate Voluntary Mandate • January 1, 2021 Soft Launch • Summer 2020 • Pre-payment • CCR Rule in • Began October claims review Effect 1 st , 2019 State exploring live-in caregiver solutions 24
States that have requested a Good Faith Exemption 25
Live-in Caregiver Definition • The Department is currently working to develop a live-in caregiver definition with assistance from the Participant Directed Services & Family Caregiver Subcommittee • This definition will help guide the solution for exempting live-in caregivers from EVV • The Department welcomes comments at evv@state.co.us 26
Soft-Launch • Began October 1, 2019 when the State EVV Solution and Data Aggregator went live. • Providers may begin to collect EVV data and transmit to the Department. • Optional participation until EVV is mandated, estimated late summer 2020. • Opportunity to familiarize providers with EVV prior to claims integration. Claims will continue to pay and EVV errors will appear on remittance advice. • Opportunity for caregivers to practice EVV collection and for members to become accustomed to EVV. • Help the Department identify and develop supplemental training materials. 27
Training Credential Check-in Email: CO-HCPF-EVVProviderHelpdesk@etraconline.net Phone: (855) 871-8780 28
Questions or Comments
Provider Choice System Process Overview
Phase 1: Outreach ✓ Providers determine if they will use the State EVV Solution or a Provider Choice System ✓ Provider review technical specifications ✓ Providers coordinate with contracted EVV vendor ✓ Provider Choice Systems reach out to Sandata begin testing process Phone: (855) 871-8780 Email : CO-HCPF-EVVProviderHelpdesk@etraconline.net 31
Phase 2: Setup for Interface Testing with Sandata 1. Providers register with Sandata to request test credentials 2. Sandata sends testing guide and checklist to providers 3. Sandata creates an account to support testing efforts 4. Sandata will provide contact information for Sandata’s technical interface support team for questions and issues 32
Phase 3: Interface Testing 1. Test files are uploaded by vendor and checklist is filled out 2. Provider sends completed checklist from vendor to Sandata and requests validation 3. If unsuccessful, the checklist marked with erroneous files/scenarios is sent back to provider 4. The corrected checklist can be resubmitted until all errors are corrected 33
Phase 4: Production Ready 1. Provider testing is successful 2. Sandata sends production credentials to provider 3. Provider takes aggregator training 4. Providers start sending EVV data to Department for Soft-Launch 34
Provider Choice System Update
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