Texas Council on Consumer Direction: EVV Update

Blog
July 5, 2019
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Electronic Visit Verification (EVV). Alisha Brown[1] and Jordan Nichols made the presentation.

We received some questions from last meeting, and I want to go over our responses. Regarding general updates, we’re constantly working with policy to finalize decisions on FMSAs and CDS employers. We’ve also been working on training and I’ll provide an update on that as well. Additionally, we’ve started our EVV-CDS Workgroup which meets monthly.

Q1: The Council is interested in helping/providing input on the development of EVV training. Is this possible? A1: Yes. The State encourages input. Our training dates are available and soon, we will have information posted regarding instructor-led training. This is face-to-face and will be open to our traditional providers as well as our FMSAs and CDS employers. Currently, we do not have a training session exclusively for CDS employers. There are three different training phases: 1) conducted by EVV vendor, vendor will be training on EVV system; 2) will be conducted by the Texas Medicaid Healthcare Partnership, discussion will be the EVV aggregator and the EVV portal; 3) HHSC and MCOs will be conducting training on EVV policy. All of this information will be posted. We’ll also have our computer-based training; both HHSC and TMHP have learning portals for registration. There will also be webinars, and we are posting our toolkit (1st and 15th of every month). On the 22nd, there is a live Q & A session.

Q2: Has HHSC conducted a cost/benefit analysis of exempting CDS EVV and potentially losing the FMAP? A2: We talked to CMS and unfortunately, they would reduce the FMAP at the authority level. EX: 1915(c) Waiver, 1115(c) Waiver. If we exempted CDS or don’t do EVV for CDS, CMS would reduce funding at all of those authority levels. It’s not specific to CDS services, so, it could reduce the FMAP for all personal care services. We do not see that as an option.

Q3: What are the dates for EVV training for CDS employers? A3: They will be posted on website, but training begins August 1, 2019.

Q4: By what date will CDS employers using EVV be required to be in compliance? The Council understands that there may be a grace period following initial implementation where CDS employers and FMSAs are still learning the EVV system. A4: January 1, 2020 begins EVV. If there is not a matching EVV visit transaction, the claim submitted will be denied by your payor. We have a grace period for compliance oversight, which consists of EVV usage and goes into effect on September 1, 2019, (“but would be ready for those that begin 1/1/20”). There would be no action taken, no minimum requirement, but we want you to use the system. That’s the purpose of compliance oversight. There will be a one-year grace period. We’ll be examining the data to make sure this is a good measure to ensure that those required to use EVV are using it.

Q: If I am an employer and unaware of EVV, who will inform me? A: An FMSA will tell you, and we have the information on our website.

Q: Some states have an alternate EVV for CDS. Are there also some states that allow an extension? A: You’re referring to the Good Faith Effort. CMS released that information in May, and we’re in the process of reviewing it. We are currently working with HHSC leadership to determine if we qualify for a delay, but CMS won’t accept requests until July 1. Q: If you request an extension, will that information be on the website? A: Yes, any formal change in the implementation plan will be communicated accordingly. However, we need to keep working towards the Jan. 1, 2020 date until anything official is announced.

EVV UPDATE: Requests from States for Good Faith Effort Exemptions [here]

Section 12006(a) of the 21st Century Cures Act (Cures Act) mandates that states implement electronic visit verification (EVV) for all Medicaid personal care services by January 1, 2020 and for all Medicaid home health care services by January 1, 2023, or otherwise be subject to incremental federal medical assistance percentage (FMAP) reductions. The Cures Act includes a provision that allows states to delay implementation of EVV for up to one year if they can demonstrate they have made a good faith effort to comply and have encountered unavoidable delays. This notice provides states with information regarding the process to request a good faith effort exemption.

  • CMS will accept requests for good faith effort exemptions for personal care services beginning July 1, 2019. CMS strongly encourages states to submit good faith effort exemption request by November 30, 2019.
  • States are required to use the form titled “Good Faith Effort Request Form – Personal Care Services” when submitting their requests.
  • Only the State Medicaid Agency Director or his/her designee can submit this form.
  • Please send completed forms to the EVV mailbox at EVV@cms.hhs.gov with the subject line “[State Name] EVV Good Faith Effort Exemption Request.” The EVV mailbox will acknowledge receipt of the form. Only one form per state should be submitted.
  • Within 30 days of receipt of the state’s request the CMS EVV mailbox will send a letter attached in an email and signed by the Director of the Division of Long-Term Services and Supports confirming whether the state’s request has been approved. If the state’s request is not approvable, CMS will inform the state of the reason(s) the request was not approved and will offer to schedule a conference call with the state. The state will have the opportunity to revise and resubmit its request.

Please be advised that the Cures Act provision on good faith effort exemptions does not provide CMS with authority to delay the FMAP reductions for more than one year. If you have any questions, please email EVV@cms.hhs.gov or contact your CMS Regional Office.

Cont… Regarding alternate EVV, there is a lot of flexibility in the way states implement. I don’t believe there is a hard requirement that the system used by traditional providers has to be the same as CDS. We’ve been collecting data on system and business requirements that we’ve shared with TMHP and the potential vendors so that they know how they’d need to configure their systems to accommodate CDS. Vendors are currently working to customize their systems.

Q: Will allowable expenses be increased for people who currently can’t afford the technology to implement this system? A: We received increased funding for 2020-21 CDS employers so that they can purchase equipment for EVV. We’re still working to get the money allocated; there may be other policy changes required to increase the limit. However, we intend to have more money available for that.

Q: Is there a punch list of items that would prompt examining the option for an extension? Is there a team for that? A: Yes, it’s the EVV Operations Department working in collaboration with Policy Development and Support to determine the criteria.

Q5: Will HHSC be adding other EVV vendors in addition to Vesta DataLogic? A5: Yes. We have not announced them because we’re ensuring that they meet all of the requirements, but the plan is to make three[2] vendors available in the Fall of 2019.

Q6: Will CDS employers and employees be restricted to one EVV device? A6: They can use multiple devices; the attendant and employer can collaborate on the best methods. Landline, mobile app, etc.

 

For the full report, follow this link.

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  1. Spelling uncertain.
  2. Speaker’s original phrasing did not make it clear whether there would be three additional or three total.