21 Jun Florida Electronic Visit Verification
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FLORIDA EVV INFORMATION
EVV is a requirement in the state of Florida. In this edition of the Alora Home Health blog, we’ll take a look at EVV in Florida, exploring the start date, FAQs, general information, as well as resources for you to learn more about Florida’s 2020 EVV implementation schedule.
Florida Electronic Visit Verification
The nationwide march towards EVV began with the creation of the 21st Century Cures Act. The 21st Century Cures Act mandates the following:
“States must require Electronic Visit Verification (EVV) use for all Medicaid-funded PCS by January 1, 2020 and HHCS by January 1, 2023. Otherwise, the state is subject to incremental FMAP reductions up to 1% unless the state has both made a “good faith effort” to comply and has encountered what state defines as circumstances causing agencies “unavoidable delays.”
Florida is defined as an “Open Model” state, which essentially means that providers are free to select and utilize whatever EVV system they deem as suitable. There is a requirement that whichever Florida EVV system they choose, MUST collect the 6 data elements outlined within the 21st Century CURES Act. Those requirements are:
- The exact time and date that any services were performed by the caregiver
- The precise start time and end time of the services rendered
- The specific type of in-home services the caregiver performed
- The exact location where the in-home services were provided by a caregiver
- The legal name of the caregiver who performed the services
- The legal name of the patient/individual who received the services
When did Florida EVV Start?
FLORIDA EVV IMPLEMENTATION DATE
AHCA initially directed SMCC health plans to require providers to electronically verify all visits for home health and personal care services starting December 1, 2019. Enforcement of payment penalties for non-compliance was then set to begin on February 1, 2020.
EVV’s Updated GO-LIVE date – December 1, 2020
The Agency for Health Care Administration announced the implementation date for electronic visit verification (EVV) for behavior analysis (BA) services as December 1, 2020 for the pilot Regions 9, 10, and 11. Providers must bill through the Tellus EVV System and must no longer bill via the Medicaid Provider Web Portal. Beginning December 1, 2020, claims billed through FMMIS will not be paid. Providers should act now to reorient themselves to using the Tellus EVV System and take advantage of the options outlined below for training and technical assistance. Florida providers may still use an alternate EVV system of their choosing so long as it meets the requirements of aggregator data transmission through the state-provided system.
What are Florida’S EVV Requirements?
Section 409.9132 of the Florida Statutes states that Home Health care agencies operating in the state of Florida are to choose a capable vendor to operate EVV (Electronic Visit Verification) program of home health services provided through the fee-for-service delivery system. The electronic visit verification system they select has to meet the following requirements:
- The selected EVV System must verify the utilization and delivery of home health care services inclusive of home health visits, private duty nursing, & personal care services
- The selected EVV System must have the technology to be able to identify and deliver details of the home health care services while inhibiting fraudulent or inaccurate billing for the services
- The selected EVV System has to provide an interface for electronic billing and require electronic claims submissions for home health care services.
Florida Medicaid Aggregators
Florida Medicaid has chosen three aggregators:
- HHA Exchange
- Coastal Care
FLORIDA AHCA EVV SYSTEM
Electronic visit verification is required for all home health services including home health visits, private duty nursing, and personal care services. According to AHCA, providers must:
• Verify delivery of services using an EVV system at the start and conclusion of every home health service visit.
• Complete claims submissions through the vendor’s system, verifying that delivered services are compliant with prior authorizations before claims can be processed for payment.
MCO CONNECTION INFORMATION
If an agency has contracted with one of the MCO’s, the agency may continue to use their current EVV solution, so long as that solution can transmit accurate information to the MCO’s visit confirmation and claims platform. A best practice would be to confirm with each individual payer to ensure their individual deadlines for visit submissions and claims through their selected vendor. Those contracted with Humana, Molina, Staywell, or Sunshine Health, should submit visit confirmations and transmit claims through the HHAeXchange Platform.
Visit the HHAeXchange Provider Info Center for more details, dates, training sessions, and resources.
FLORIDA AGGREGATOR INFORMATION
AHCA has contracted with Tellus to aggregate EVV data on behalf of the Florida. It is not required that agencies directly contract with Florida’s state aggregator. Agencies will incur no additional fees in transmitting EVV data to the State of Florida. In a majority of cases, whichever EVV platform utilized, including HHAeXchange, will transmit this data to the State’s aggregator on the agency’s behalf.
FLORIDA EVV PENALTIES
If an agency provider operating in the state of Florida fails to comply with the state’s EVV rules, the agency may be subject to non-payment of claims or denial of claims, as well as a variety of fines, sanctions, suspensions, or termination from the Florida Medicaid program.
With Florida’s status as an Open Model state, agency providers are free to any 21st Century Cures act compliant EVV solution.
TOP FLORIDA ACHA FAQs
Quick Questions & Answers:
Q: Is the state providing training to assist agencies in using an EVV system?
A: Yes, training has been made available to help agencies in using the Tellus EVV system available on their website.
Q: Does the EVV system allow usage with a mobile app?
A: Yes. Download the appropriate Tellus EVV mobile app for your chosen device. The administrator console and claims console are web-based applications accessible from any device with a web browser. Go to Visit http://www.4tellus.com for more info.
Q: Can the EVV system be utilized without a tablet, smartphone or other mobile device?
A: Usage of a mobile device is required for access. In the absence of such a device, users will need to call your administrator from the member’s home for assistance.
Q: Can the AHCA EVV system integrate with other EVV systems?
A: Yes, the AHCA EVV system can integrate with other systems. Call the AHCA EVV support line for more information at (833)-242-2388
Other helpful links:
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