Oregon Electronic Visit Verification: True or False Series

As we get closer to Oregon’s planned Electronic Visit Verification roll out for Personal Support Workers statewide, ODDS has begun posting a series of Fact or Fiction Facebook posts to help community members better understand what’s happening and what to expect.

Currently, there is an EVV pilot happening in southern Oregon with one brokerage and one county (Creative Supports Inc. and Jackson County). Full implementation is expected sometime summer 2019. Information and training details are all forthcoming.

If you need a refresher, here’s some details from Oregon Developmental Disabilities Services:

“EVV is part of a federal law that was passed by Congress in 2016. The 21st Century Cures Act requires states to verify the delivery of Medicaid-funded Attendant or Personal Care services in real time (at the time the service is occurring) from providers. The EVV system must electronically capture the following information at the time the service is occurring:

  • Type of service performed
  • Individual receiving the service
  • Date of the service
  • Location of the service
  • Individual providing the service
  • Time the service begins and ends

EVV will be required of all PSWs in Oregon by 2019. The 21st Century Cures Act also recommends that states seek stakeholder input from family caregivers, PSWs, and individuals receiving services along with other stakeholders when developing their EVV systems. See PDF presentation for more information.”

Be sure to follow the eXPRS Facebook page and bookmark the ODDS Electronic Visit Verification Project web page to stay on top of the latest developments.

Check out the slideshow below with a few of the True or False posts from the eXPRS Facebook page.

eXPRS EVV True or False

eXPRS EVV True or False

eXPRS EVV True or False

eXPRS EVV True or False

eXPRS EVV True or False

eXPRS EVV True or False

ODDS Announces Change to Provider Agency Billing Process

The following message was emailed to Provider Organization contacts by the six Portland metro area brokerages on 02/02/2019.

 

IMPORTANT NOTICE TO OREGON PROVIDER ORGANIZATIONS
RE: APD-PT-19-003* Policy Transmittal: Agency Billing Activities Effective 2/1/2019

As of Friday, 2/1/19, most eXPRS submissions by provider organizations will automatically be paid by ODDS without case management review. (Service codes OR539, OR570, and OR310 are excluded from this change.) The Oregon Office of Developmental Disabilities Services (ODDS) will conduct post-payment reviews of provider organization documentation. This change may expedite payment to some provider organizations, but it does not change documentation requirements.

Oregon Administrative Rule 411-415-0090 requires Case Management Entities (both CDDPs/counties and Brokerages) to conduct extensive and specific monitoring of services including but not limited to:

  • Ensuring all services provided align with those authorized in the ISP
  • Confirming support and progress toward goals
  • Confirming individual choice is being honored

The review of provider organization progress notes is an invaluable tool in meeting these monitoring mandates. For this reason, the six Portland metro-area brokerages will continue to expect to receive progress notes for all services delivered. Per the state’s transmittal, these notes must include:

  • Customer name
  • Provider of service
  • Dates of service (the date range is sufficient)
  • Units of service provided (total number of units for the period is sufficient)
  • A progress note summarizing the service provided and progress toward goals (weekly or monthly summaries are perfectly acceptable)

As guidance, please review the following from the Indirect Case Management Monitoring Worker’s Guide:

Adequate provider agency progress notes focus on describing the supports a person received to achieve the desired outcome. These include the ADL, IADL, medical and behavioral supports identified on the ISP as being needed. The notes should focus on the specific activities (i.e. “visited a museum”) only insofar as they are important to achieving the desired outcomes as described in the ISP. Simply stating the name of the service associated with the procedure code is not sufficient (i.e. “Provided Day Support Activities” is not an adequate progress note to support a claim by the agency or for the purposes of indirect monitoring.) An adequate note will allow a SC/PA to determine if the services are consistent with those authorized in the ISP. Provider agency progress notes are also a place for the provider to convey observations about possible changes in support needs, challenging behaviors and a wide variety of topics. These reported observations should be reviewed by the SC/PA for their potential impact on risk identification, new person-centered information, and service planning. The SC/PA’s supporting progress note should reflect their assessment of the observations and the actions they will take in response, if any.

This excerpt demonstrates that progress notes are an important tool in monitoring supports and communicating changes in an individual’s needs and choices. As such, we request that providers submit progress notes for all supports no later than one month after the provision of services. For example, notes for services provided in February will be due by the end of March.

In compliance with the transmittal, we will be notifying ODDS when we do not receive progress notes within the 30-day window.

We anticipate that issues with overlapping billings will likely continue. As CDDPs/counties Brokerages are no longer part of the invoicing and payment processes, providers will need to seek resolution of these issues from ODDS.

Finally, we trust that our provider organization partners share our values with regard to continuing to offer customers the authority to review and authorize their services via signature. We will have one-on-one conversations with each of our customers regarding their options, and plan to solicit broad customer and family input on how to ensure choice continues to be offered and honored.

Thank you for your continued partnership and your service to our shared customer base as we work together through this next transition.

 

*Source: http://www.dhs.state.or.us/policy/spd/transmit/pt/2019/pt19003.pdf

 

 

Update on 2019 PSW Electronic Verification Visit Requirement

On December 11th, 2018, the Oregon Office of Developmental Disabilities Services sent the following message to Personal Support Workers statewide:

This message is to notify Personal Support Workers about the latest news with Electronic Visit Verification (EVV).

A new federal law requires that states implement an electronic way for verifying attendant care services, called Electronic Visit Verification (EVV).

EVV is required for all Medicaid personal care services and home health services that require an in-home visit by a provider.

EVV is a new way to collect information in eXPRS. It will record these federally-required items in real time:

  • Personal Support Worker (PSW) name
  • Person receiving services
  • Type of service
  • Date of the service
  • Time the service begins and ends
  • Location of the service

The Office of Developmental Disabilities Services (ODDS) will be making changes to eXPRS that will allow it to be used for EVV.

A pilot for EVV in Oregon will take place in early 2019. EVV will be required of all PSWs in Oregon by 2019. Information will be sent to PSWs regarding full implementation in spring 2019.

EVV will work on smart phones and tablets that can access the eXPRS website. eXPRS will be changed to have a website made especially for phones and tablets. There will be trainings to help PSWs learn how to use this new part of eXPRS.

For PSWs who do not have a smart phone or tablet with Internet access, there will be an exception process. You will get more information about this before EVV is required. 

For more information and to subscribe to get the latest updates:  

 https://www.oregon.gov/DHS/SENIORS- DISABILITIES/DD/PROVIDERS-PARTNERS/Pages/evv.aspx

Related: Brokerage Association Post on EVV May 2018