electronic visit verification - colorado · 2019-10-15 · testing state system and aggregator...
TRANSCRIPT
Electronic Visit Verification
General Stakeholder Meeting
October 15, 2019
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Our Mission
Improving health care access and
outcomes for the people we serve
while demonstrating sound
stewardship of financial resources
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Welcome Stakeholders
•Restroom locations
•HCPF Introductions
4
Meeting Purpose
The purpose of this meeting is to engage providers,members, and other stakeholders as the Departmentworks to implement EVV for community based servicesoffered through both the State Plan and Waivers.
And specifically to:
• Review EVV, the legislative mandate, and the scope of implementation
• Discuss EVV Project Updates
• Review current implementation timeline
• 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
Agenda
Introductions
Brief Overview of EVV
Service Types Required for EVV
Overview Colorado EVV Technologies
Good Faith Exemption Request
State System & Alternate Vendor Update
Training Check-In
What is 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
• 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 intends to implement EVV for all Colorado required services in late summer 2020.
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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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
• 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 (requiring in-home visit setup) Delayed
Which Services Require EVV?*
*Subject to change
Behavioral Therapies
Consumer Directed Attendant Support
Services Home Health Homemaker Hospice
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
NursingRespite and Youth
Day Speech Therapy
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Service Types Groupings
Service Location
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• The Department recognizes that EVV services can happen in the home or in the community.
• It is essential that EVV does not disrupt this flexibility of service 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
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
✓ 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
• 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
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Colorado EVV Implementation Update
Early Adoption -Voluntary Soft Launch
•Began October 1st, 2019
Colorado Anticipated Mandate
•Summer 2020
•CCR Rule in Effect
CMS Mandate
• January 1, 2021
•Pre-payment claims review
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Good Faith Effort Request Approved
State exploring live-in caregiver solutions
States that have
requested a Good Faith Exemption
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• 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 [email protected]
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Live-in Caregiver Definition
• 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.
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Soft-Launch
Questions or
Comments
Provider Choice System Process Overview
✓ 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 : [email protected]
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Phase 1: Outreach
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
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Phase 2: Setup for Interface Testing with Sandata
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
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Phase 3: Interface Testing
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
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Phase 4: Production Ready
Provider Choice System Update
• Business demand for provider choice vendors is higher than expected
• Due to the high volume of alternate vendor interface requests, the Department has exceeded current system capacity
• Currently, 41 alternate EVV vendors connected to Sandata
• If your alternate vendor has already interfaced, there is no delay for interfacing
• If your alternate vendor has not already interfaced, there will be a delay in interfacinguntil January 2020.
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Alternate Vendor Interface
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Interfaced EVV vendors Accel
Aidetech
Alora Health
Ampersand
August Systems
Axiscare
Axxess
Brightree
Brightstar
Brittcosoftware
Careficient
Carewatch
Celltrak
Clearcare
Code Metro Npa Works
Complia Health
Connect A Voice
Delta Health Technologies
Epic Systems
Formdox
Generations
HCBS Solutions
Hha Exchange
Interim
Itherapydocs Inc
Kantime
Lovely Homecare
Maxim
Mckesson
Motley Designs
Netsmart Homecare
Pointclickcare
Primary Solutions
Riversoft
Salo Solutions
Shoshana Technologies
Solana
Stryker
Therap
Wellsky
Xoomia As of 10/10/2019
State Solution Update
Batch Upload requests are available as a one-timecourtesy to provider agencies that serve 80 or more members using Medicaid-covered services by offering a spreadsheet for the agency to populate with their attendants and individuals using Medicaid-covered services. This must be completed prior to entry of data into the EVV system.
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One Time Bulk Upload
• Load members into the State EVV Solution
• Load attendants and agency staff info into the State EVV Solution
• Process is facilitated by Sandata
• To request the one-time bulk upload, providers should contact Sandata EVV Support.
Email at [email protected]
Phone (855) 871-8780
NOTE: Providers using a Provider Choice System are not eligible for the batch upload.
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One Time Bulk Upload
Questions or
Comments
Electronic Visit Verification Roadmap 2019
Electronic Visit Verification Implementation Roadmap
2018-2020
Project Kickoff 2018
Develop and
Finalize Training
Plan
Develop Colorado Rules and Regulation
Draft
Collect Stakeholder
Feedback on EVV CCR
User Acceptance
Testing
State System
and Aggregator
LiveCollect Stakeholder
Feedback on
Scheduler
Provider Welcome
Letter
Register for
Training
Begin Soft
Launch
Interface
Testing Provider Training
Call Center Available
Go Live Mandatory
Use
Summer*
2020
Release Technical
Specifications for Provider
Choice Systems
*Subject to change
Training Overview
Types of Training
INSTRUCTOR LED
CLASSROOM TRAINING
INSTRUCTOR LED WEB-BASED
WEBINAR TRAINING
SELF-PACED ELEARNING INFORMATION
Participant Guide
User Manual
Caregiver FAQ
Caregiver Letter
Coming Soon
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Training Materials
EVV Project Accomplishments
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Roadshow completed
Technical Specifications
released
Two EVV overview videos
available online
Provider Welcome
Letter
Service Types
Document Completed
Training Registration
live
New EVV website
State EVV System
Live
Questions
48
Thank you!
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