Good Afternoon!
Yesterday the Ohio Department of Medicaid (ODM) hosted their monthly EVV Stakeholder meeting. ODM shared a lot important updates on a variety of topics relating to EVV. Updates include information on ODM’s good faith exemption application,
alternate vendor demonstration process, Sandata device management, DODD claims analysis, and Phase 3 update.
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Good Faith Exemption
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In October the Ohio Department of Medicaid (ODM) submitted a Good Faith Exemption to the Centers for Medicare and Medicaid Services (CMS). In November, CMS approved the exemption request.
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The exemption would delay a decrease in federal match funds for not fully implementing EVV from January 1, 2020 to January 1, 2021. ODM now must implement EVV in the relevant services by 1/1/2021.
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CMS told ODM they do not need to have pre-payment denial of claims based on insufficient or no EVV units by this date. However, ODM must be using EVV in some way to validate claims if denials have not begun by 1/1/2021.
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ODM still does not have a date set for claims denials for any phase.
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The exemption approval does not delay an Ohio provider’s obligation to participate in EVV as outline in
5160-1-40.
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Alternate Vendors
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18 alternate vendors have demonstrated their platforms for ODM so far and Sandata, 5 platforms have passed the demonstration. Additional demonstrations are scheduled for the coming weeks.
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ODM is working with alternate vendors that have not passed their demonstration to get the platforms in compliance.
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If your vendor has not passed their demonstration yet, you do not need to automatically switch to the Sandata system or an alternate system.
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Vendors have until 7/1/2020 to get their platforms in compliance. If an alternate vendor is not able to pass the demonstration by this date, providers using the alternate platform will need to transition to the Sandata system
or another alternate vendor.
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ODM will start reaching out to alternate vendors next month that are sending data to the Sandata aggregator and have not scheduled a demonstration.
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Device Update and Recovery
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Due to operating system changes implemented by Apple and Google, a few of the state-provided LG devices for the Sandata system need to be returned to the Sandata distribution center to be updated. About 4,400 devices need to be
updated. Providers with these devices will need to send the devices back to the distribution center and will receive replacement devices.
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About 3,200 providers across both phases have one or more these devices that needs to be updated.
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ODM will begin email communication with providers who have these devices over the next few weeks.
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If you have one of these devices you will get a message in eTRAC about the swap and then shortly after a new device will arrive. You will need to send the out-of-date device back to the distribution center.
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Providers will receive a pre-paid envelope to send the device that needs to be updated back in.
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ODM is beginning an effort to recover unused devices. ODM will be reaching out to providers who have devices that have not been used in the past 6 months.
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Providers with these devices will receive email communication from ODM shortly on how to return the device.
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If you stop providing services that require EVV to someone, please make sure you are returning their state-provided device.
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County Boards
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County Boards now have access to reports on the EVV utilization for HPC billed in 15 minute increments provided in their county. Some have started their own outreach based on these reports.
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Phase 2 Outreach
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ODM is working on an outreach effort to Phase 2 providers who are not utilizing EVV at all.
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If you are still not participating in EVV but should be, you will receive communication from ODM for each payer you provide services under regarding your agency’s non-compliance. This may result in multiple communications from
ODM.
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DODD Claims
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During the most recent analysis period, a little over half of relevant claims do not have any EVV units. The majority of claims with EVV units have enough units that claim would not be denied.
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The number of claims that have some but not enough EVV units to be paid is has decreased since EVV implementation while the number of claims with enough EVV units has increased since implementation.
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Phase 3
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Phase 3 includes participant directed services and some home health therapies (occupational therapy, physical therapy, and speech therapy).
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Phase 3 training is set to begin in fall of 2020 with an implementation date of January 1, 2021.
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Phase 1 and Phase 2 providers offering Phase 3 services will need to take a bridge training before implementing EVV in their services.
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There will be a special focused training for participant directed services.
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EVV in participant directed services will look similar to EVV in Phase 1 and 2 services with the additional ability of financial management services to view EVV visits in the Sandata system.
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There will likely be some additional requirements alternate vendors will need to build into their systems but those have not been finalized at this time. It has not been determined in an alternate vendor will need to go through
an additional demonstration.
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ODM hopes to have the business rules for alternate vendors developed soon.
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More information on Phase 3 should be released over the coming months.
I have not received the presentation yet but will share it as soon as I do! Please let me know if you have any questions!
Have a great day,
Christine
Christine Touvelle, MLS
Policy Analyst
Ohio Provider Resource Association
O- 614-224-6772
1152 Goodale Blvd.
Columbus, Ohio 43212
