Transcription
Med-QUEST presents:ELECTRONIC VISIT VERIFICATIONInformational session for providersFebruary 20181
Introductions Med-QUEST(MQD) staff VCC check-in2
Agenda Overviewof Federal mandate – 21st CenturyCures Act Med-QUESTgoals for Electronic VisitVerification (EVV) Discussion3
st21Century Cures Act Passedby Congress in December2016 Containsmany requirements,including EVV4
st21Century Cures Act Intentof the act is to improvequality of care through: Research Enhancedquality controls Strengthenedmental health parity5
21st Century Cures ActStates are required to implement an EVVsystem for Personal Care Services and HomeHealth Care provided in a member’s home by: Jan1, 2019 for Personal Care Services(Attendant care, respite care & habilitation services) Jan1, 2023 for Home Health Care Services6
21st Century Cures ActStates shall work with providers to ensure thatEVV system is: Minimally burdensome Health Insurance Portability andAccountability (HIPAA) compliant Mindful of best practices Developed and implemented with stakeholderinput7
st21Century Cures ActWhat is EVV? EVV is a tool for electronically capturingconfidential point of service information forcertain home and community based services EVV is a telephone and/or computer basedsystem that documents the precise timeservice delivery begins and ends. EVV system will also have back up methods forcollecting data.8
st21Century Cures ActEVV system must electronically verify: Type of service performed Individual receiving the services Date of service Location of service delivery Individual providing the service Time the service begins and ends9
21st Century Cures ActPotential benefits of EVV:Improves program efficiencies by: Eliminating the need of paper documents to verifyservices. Facilitating flexibility for appointments andservices. Strengthens quality assurance for PCS and HHCS by: Improving Health and Welfare of individuals byvalidating delivery of services. It is important to note that EVV is not a completereplacement for on‐site, in‐person casemanagement visits. 10
21st Century Cures ActPotential benefits of EVV (cont’): Aims to reduce potential Fraud, Waste, and Abuse(FWA): Validatesservices are billed according to theindividual’s personalized care plan by ensuringappropriate payment based on actual service delivery. Ispart of the pre‐payment validation methods thatallows individuals and families to verify servicesrendered.11
21st Century Cures ActWill not: Limitthe services provided Limitprovider selection Limitthe individual’s choice of caregiver Impedehow care is delivered Establishan employer-employeerelationship12
st21Century Cures ActStates are required to provide trainingto providers and members on the useof the EVV system13
21st Century Cures ActHawai’i will lose Federal match for services forfailure to comply to requirements14
Med-QUEST goals Timelyservice deliveryincluding real time service gap reporting and monitoring Administrativeburden reducedrelated to hard copy timesheet processing Costsavingsprevention of fraud, waste and abuse15
Med-QUEST plan Scopeof EVV Requirement in Hawaii ProposedEVV Design Collaboration Stakeholderwith ArizonaInvolvement16
Med-QUEST plan Scopeof EVV Requirement in Hawaii Nursingservices provided in the home and thecommunity 1915c PAB services provided in the home and thecommunity Personal Assistance/Care services ( PA/PCS) providedin the home and the community Home Health Agency services Self Direction (SD)/ Consumer Directed Services (CDS)programs17
Med-QUEST plan Proposed OneEVV Designstate-wide EVV system Existingprovider EVV systems may be maintainedas long as they meet system requirements and caninterface with the state system Ifthe state develops the system: 90% 75%of development costs are reimbursedof ongoing costs are reimbursed18
Med-QUEST plan Collaboration Nearlywith Arizona20 year history of collaboration with AZ Systemprocurement led by Arizona team, inpartnership with MQD Systemconfiguration & testing led by Arizonateam, in partnership with MQD Systemrollout and training let by MQD team19
Med-QUEST plan StakeholderInvolvement MQDEVV ers/electronic-visit-validation.html Information Publicsessionscomment & feedback Providersurvey20
Discussion21
Resources MQDEVV /electronic-visit-validation.html 21stCentury CURES use-bill/34/text22
Mahalo!23
21st Century Cures Act Potential benefits of EVV: Improves program efficiencies by: Eliminating the need of paper documents to verify services. Facilitating flexibility for appointments and services. Strengthens quality assurance for PCS and HHCS by: Improving Health and Welfare of individuals by validating delivery of services. It is important to note that EVV is not a complete
