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Over the past year, the Ohio Council for Home Care and Hospice has been advocating for the state Department of Medicaid to make changes to its Electronic Visit Verification system. This month, OCHCH announced that those efforts have produced some results. A report summarized four areas:
During the first EVV Summit in December, OCHCH members asked the association to get an independent legal opinion on how EVV could impact home health agencies. The concern was that using EVV would require agencies to provide front-line staff with new forms of Protected Health Information in order for the system to work, thus creating greater exposure to a HIPAA violation or breach.
In response, OCHCH worked with a HIPAA attorney to determine the level of risk EVV poses to home health agencies due to new PHI needs. The attorney concluded that ODM is within its authority to require the use of PHI — in this case the Medicaid ID. The OCHCH memo said, "There is nothing we can do to challenge ODM’s requirement to use the Medicaid ID. However, the attorney also believes this requirement puts agencies at greater risk of a HIPAA violation or breach than they were prior to EVV." The attorney advised OCHCH to explain the following to its members.
Agencies are already required to use reasonable policies to protect PHI. As long as those policies exist, agencies are protected from government action. Consequently, if an agency’s HIPAA policy is updated to address the new EVV risk, then they will be protected even if an employee violates the policy. Agencies will still be required to report a breach but, with an updated policy, agencies should have no more liability with Medicaid ID and EVV than they do today.
OCHCH has created guidance explaining the issue in more detail and giving direction as to how agencies can protect themselves from HIPAA issues due to EVV. This guidance is titled, "Electronic Visit Verification and HIPAA: What Providers Need to Know."
In May, the Ohio Department of Medicaid (ODM) will provide one-on-one technical assistance for providers with questions about using the Sandata system at the Center for Excellence in Columbus. ODM staff will be on-site to work directly with providers to address their specific questions and problems they’ve experienced since the go-live date in January.
The dates include:
May 1: Noon to 4
May 3: 9am to 1
May 7: 9am to 1
May 11: Noon to 4
ODM will be handling registration for these FREE sessions. They are putting the final details together. More information will be available soon on the ODM webpage. OCHCH will also send out more information once registration is open.
On Wednesday, April 18, ODM announced that they are delaying and changing the implementation for EVV, including EVV rule changes. Originally, ODM had expected a “hard” implementation by turning-on the billing component of EVV on July 1—meaning that agencies claims would begin being impacted by their EVV utilization. Based in large part on OCHCH’s advocacy efforts, ODM has agreed to delay the implementation to August 1 and instead will use a “soft” implementation.
Beginning August 1, ODM will use a “pay and post” implementation process in which claims will be paid even if there are inconsistencies with the EVV data. Providers will need to be using EVV by August, but claims won’t be denied. Instead, ODM will post edit information detailing any inconsistencies that exist if the claim wouldn’t have been paid during live billing. It’s not clear when live billing will eventually go-live, but the new soft implementations approach will give providers more time to perfect their EVV processes.
ODM also announced they will delay changes to the EVV rule until later in the year. ODM recently made a couple of changes to the current EVV rule that eliminated the 90-day exception and included details on the Sandata smart phone app, but they’ve decided to wait to make any more changes to the rule until other issues are addressed, including the details of bringing other population on-line with EVV.
ODM also announced Wednesday that in addition to reducing the list of exception codes, ODM is also turning-off the GPS exceptions all together. While providers will still be required to use GPS technology as part of their EVV component, providers will no longer be required to clear an exception relating specifically to GPS.
It’s not clear if ODM will turn-on the GPS exceptions codes again in the future. At least for the time being, this change will reduce the agency exception requirement, which is a positive development.
After two successful EVV Summits, OCHCH is planning another event that will focus on alternative EVV vendors. Details on the Alternative EVV Summit are not yet available, but please stay tuned for more information. OCHCH will be announcing the date and offer registration very soon.
OCHCH will continue to engage ODM and keep you updated on developments related to EVV. If you have any questions, please contact OCHCH Policy & Advocacy Director Andrew Yogmour at Andrew@ochch.org or 614-885-0434, ext. 208.
©2018 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared as a letter from OCHCH to its members. Reprinted by permission in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission of OCHCH. Andrew@ochch.org or 614-885-0434, ext. 208