Current through Register Vol. 48, No. 38, September 20, 2024
a) In-home agency providers who provide
homemaker services, maintenance home health services, and/or respite services
shall utilize their choice of an Electronic Visit Verification (EVV) system
that meets the requirements of this section when providing services to HSP
Customers and shall:
1) provide documentation
to verify implementation and use of the EVV system that meets the requirements
of this section;
2) adopt internal
policies and procedures regarding the EVV system;
3) provide training and technical assistance
to in-home agency field workers who use the EVV system; and
4) submit monthly billing statements to the
HSP local office or health plan managing the Customer case within 15 days of
the end of the service period.
A) Each
statement must correspond to the providers EVV data, as defined in
686.1630(c)(3),
for the same time period; and
B)
should not exceed the service hours or fees indicated on the active Vendor
Authorization for Services form unless express written approval has been given
by the HSP.
b)
In-home agency providers that employ fewer than 10 field workers may choose to
utilize HSP's EVV system at no cost to the agency provider; all other in-home
agency providers must utilize an EVV system at the agency provider's
expense.
c) In-home agency
providers who utilize an alternative vendor EVV system shall require their
alternative EVV vendor to submit all visit verification data to the HSP's EVV
aggregator component.
d) Minimum
EVV System Requirements:
1) Technical
Functionality
A) System must capture,
identify, and track all relevant service data, including: the type of service
performed, the Customer receiving the service, the date and precise time the
service begins and ends, the location of the service delivery, and the agency
worker providing the service.
B)
System must be accessible to agency workers for input 24 hours a day, 7 days a
week.
C) System must support
changes in services, Customers, and agency workers.
D) System must allow for multiple shifts per
Customer and per agency worker per day including multiple sign in and sign out
activities.
E) System must allow
for real time data capture.
F)
System must identify and track adjustments or edits made to EVV visits after
the agency worker has input time worked.
2) Data Storage, Security, and Recovery
Standards
A) System must retain all EVV data
for up to seven years from the Customer's last date of service with the
agency.
B) Archived data must be
retrievable in a timely manner.
C)
System must comply with electronic data interchange standards under the Health
Insurance Portability and Accountability Act (HIPAA) Administrative
Simplification regulations detailed in
45 CFR
160,
162, and
164.
D) System must incorporate a disaster
recovery plan, including offsite electronic and physical storage, recovery
procedures, defined plan activation prompts, restart capabilities, and backup
hardware and operating system software.
3) Data Collection and Aggregator Interface
Standards
A) System must collect data in a
manner consistent with the HSP EVV aggregator data collection
specifications.
B) System must
submit all visit verification data to the HSP's EVV aggregator in compliance
with the approved interface and submission data specifications as provided by
HSP.
