Provider Update: July 24, 2019

To: ADvantage Case Management and Home Care Providers, and State Plan Personal Care Providers

Subject: Program Stakeholder Engagement - Electronic Visit Verification Mandate – 21st Century CURES Act Section 12006

Effective immediately, the Medicaid Services Unit (MSU) will begin sending out the attached letter (subject to updates) with all new cases and reactivations over 90 days to educate members, member advocates, and member families on the Electronic Visit Verification Mandate – 21st Century CURES Act Section 12006. The CURES Act is very specific about the components of each visit to be verified; which includes:

The type of service performed;
The individual receiving the service;
The date of the service;
The location of service delivery;
The individual providing the service; and
The time the service begins and ends.

In obligation to the public meetings act, the OHCA together with the MSU and Developmental Disabilities Services (DDS) division will host stakeholder meetings to include input from members, family caregivers and individuals who furnish case management or home care services. (Announcements of dates and locations are forthcoming).

Public Comment and Input Information

Comments and questions may be submitted via email to EVV@okhca.org or by calling 405-522-7776.

If you have any questions regarding the information provided above, please feel free to contact us via Harmony PQ.

Dear ADvantage and SPPC Members,

Use of an Electronic Visit Verification system (EVV) is a federal mandate and the service providers who serve you in your home must use EVV. Systems like these are used to prevent fraud, waste, and abuse in the delivery of the care you receive. If service providers do not use EVV, the state will lose federal funding. This federal funding allows the state to offer in-home services to qualifying Members.

WHAT IS EVV?

EVV is an electronic scheduling and billing system for in-home care providers. It is internet-based and instantly provides information about the services you receive. Providers create a record of services to be billed using your telephone. They can also use a smartphone app to create claims. EVV software verifies the caregiver is present in your home, records the service performed and compares it to your approved services.

HOW DOES EVV WORK?

The caregiver enters your home to provide a service that has been prior approved on your service plan.
The caregiver uses your home phone or your cell phone to call the toll-free EVV number or uses the free smartphone app to begin the process.
The EVV system verifies the information for you and the caregiver. The smartphone displays the information and allows the caregiver to verify it.
The system verifies that the caregiver is appropriate to provide the service for you and advises the caregiver can "check in".
When the caregiver completes the service, they call the same toll-free number or use the smartphone app to "check out".
From the telephone call or use of the smartphone app, EVV generates a claim for the service provider. After the provider reviews and approves the claim, it is submitted electronically for payment to the Oklahoma Health Care Authority.

WHY DOES YOUR PHONE HAVE TO BE USED?

The use of your phone or smartphone app allows the EVV system to locate where the service is performed, to ensure that the service is being provided to you, in your home.

SERVICE TYPES THAT WILL USE EVV:

Personal Care
Case Management
Transitional Case Management
Nursing
Advanced Supportive / Restorative Assistance
In-Home Respite
CD-PASS Personal Services Assistance
Advanced Personal Services Assistance
Various Therapies (Physical Therapy, Occupational Therapy)

HOW DOES THE EVV SYSTEM BENEFIT YOU?

EVV helps ensure your health and safety because the system alerts your provider and DHS when you do not receive services as authorized and scheduled.

Use of an EVV service assures the state will receive the funding necessary to provide your services, by reducing inappropriate billing.

HOW CAN YOU FIND OUT MORE INFORMATION OR PARTICIPATE IN TRAINING?

Additional information about EVV is available on the DHS website at:

http://www.okdhs.org/services/aging/Pages/electronicvisitverification.aspx

Dear CD-PASS Member(s),

Use of an Electronic Visit Verification system (EVV) is a federal mandate beginning January 1, 2020. Member Employers must use EVV. Systems like these are used to prevent fraud, waste, and abuse in the delivery of the care you receive. If Member Employers do not use EVV, the state will lose federal funding. This federal funding allows the state to offer in-home services to qualifying Members.