CCSP/SOURCE and EVV Update Georgia Association of Community Care Providers Tom Underwood Georgia Department of Community Health Community Care Services Program February 8, 2018

CCSP Unit Assignments

Rate Updates All new rates loaded for CCSP and SOURCE ERS, HDM and ERS rates effective Nov 2017 See Appendix S of CCSP General Services Manual or Appendix DD of SOURCE Manual for rates PSS – 15 mins for CCSP and 30 minutes for SOURCE Mass adjustment planned for Nov and Dec 2017 claims

Mass Adjustments SOURCE ADH – paid 10/31/2017 CCSP ADH Part I – paid CCSP ADH Part II – ready for approval and release CCSP and SOURCE ERS, HDM and PSS – to be scheduled soon after mass adjustments released

Special Batch Requests On hold to due Gateway update issues Should be released soon Timely filing – no need to resend Others for CCSP for DOS prior to March 2017 – send ICN on SAF if payment outstanding Please be patient until release occurs.

CCSP Medicaid Eligibility Care coordination agencies are helping clients apply on Gateway Please allow 45 days for elderly and 60 days for disabled for processing Send documents to CC if you have them Contact grei.wentz@vnhs.org for the Atlanta region Must send 30 day advance notice of discharge if for no Medicaid eligibility.

Pending Medicaid (PMAO) in SOURCE Cost share system issues being worked out Expected to role out within next 6 months if all goes well

EVV (Electronic Visit Verification) Overview EVV is a federal mandate under the 21st Century Cures Act Georgia must implement an EVV solution to comply with the federal requirement and avoid a reduction in federal funding The goal of the mandate is to reduce Medicaid fraud, waste and abuse For CCSP and SOURCE, EVV applies to private home care providers. EVV implementation for Personal Care Services must be implemented by 1/1/19 and home health care services by 1/1/23.

EVV Overview (cont’d) At a minimum, EVV systems must electronically verify: Type of service performed Individual receiving the service Date of the service Location of service delivery Individual providing the service Time the service begins and ends EVV implementation for Personal Care Services must be implemented by 1/1/19 and home health care services by 1/1/23.

EVV Overview (cont’d) EVV deploys useful technology and process changes that will benefit all stakeholders Verifies services were rendered Improve quality of care and health outcomes for Medicaid members Improve claim accuracy EVV implementation for Personal Care Services must be implemented by 1/1/19 and home health care services by 1/1/23.

EVV Implementation Approaches Provider Choice: Providers select their vendor of choice and self-fund its implementation Managed Care Organizational Choice: CMOs select their vendor of choice and self-fund its implementation State Mandated External Vendor: States contract with a single EVV vendor that all providers must use State Mandated In-house System: States create, run, and manage their own EVV system that all providers must use Open Vendor: States contract with a single EVV vendor or build their own system for providers to use, but allow the use of other EVV systems as well Source: CMS EVV Systems Session 1, December 2017

Our Timeline Ongoing communications with our stakeholders is a priority! August 2017 – Launched communications with stakeholder groups February 2018 Began internal Communications Workgroups Strategic visioning session including member advocates and providers on 2/27 April 2018 – Anticipated release of EVV Request For Proposals (RFP) September 1, 2018 or before – Anticipated award date January 1, 2019 – Deadline for implementation for Personal Care Svcs January 1, 2023 – Deadline for implementation for Home Health Care Svcs Source: CMS EVV Systems Session 1, December 2017

Our Timeline Ongoing communications with our stakeholders is a priority! February 2018 Began internal communications workgroups Strategic visioning session including member advocates & providers on 2/27 September 2018 Anticipated award date August 2017 April 2018 January 1, 2019 Launched communications with stakeholder groups Anticipated release of EVV Request For Proposals (RFP) Deadline for implementation for Personal Care Services * Deadline for implementation for Home Health Care Services is January 1, 2023 Source: CMS EVV Systems Session 1, December 2017

Next Steps Georgia will ask vendors to propose innovative EVV solutions Aggregate data from existing EVV systems Minimize impact to Medicaid members and providers Can be used in both urban and rural settings Provide a variety of training methods / options

Next Steps (cont’d) Planning and procurement process will involve representatives from member and provider communities via participation in strategic planning sessions and vendor solution demonstrations A dedicated Organizational Change Management (OCM) team will help to ensure information flows smoothly in both directions throughout the planning, procurement, and implementation of the EVV solution

Questions? If you have additional questions or suggestions regarding Georgia’s EVV Program, email: evv.medicaid@dch.ga.gov