1. Electronic Visit Verification (EVV) a) The Vendor will develop or configure, host, and maintain the EVV system. The EVV system must: Have the capability of supporting approximately 55,000 users and processing 12.5 million service records annually. Comply with the 21st Century Cures Act EVV requirements, using GPS for location verification. Provide an alternative method for collecting service location if internet or cellular access is unavailable, not relying on a landline. Integrate prior authorization data from the Home and Community-Based Services (HCBS) Data Management Contractor and Medicaid’s Fiscal Intermediary Contractor. Meet CMS Streamlined Modular Certification criteria. Enable configuration to support business rules for various programs. Provide users with real-time access to service data. Allow records to be edited and voided for at least two years from the date of service while maintaining a log of all changes made to the original record. Include a service audit tool to detect potential fraud and out-of-state services. Map services collected through EVV with the ability to filter by participant, worker, and provider; each participant’s home location must be identified on the map. Track provider compliance with LDH’s EVV utilization requirements and provide compliance data to LDH and its designees. b) Services recorded by EVV include: Personal care services (PCS) Vocational and day services, including transportation Support Coordination Supported Independent Living in-home visits Home health care services (HHCS) Participant visits by the Long-Term Care (LTC) Access Contractor 2. EVV Data Aggregator Requirements Summary The Vendor will provide data aggregator services to incorporate EVV data from LDH providers using third-party EVV vendors that meet LDH standards. Approximately forty providers currently use a third-party EVV vendor. This will include: a) Onboarding third-party EVV vendors by reviewing and approving test files. Test files shall be generated and submitted by the third-party EVV vendor in accordance with the LDH requirements. The Vendor will offer technical assistance to the third-party EVV vendor during the testing process. b) Ensure daily collection and secure storage of service records containing all required data elements from third-party EVV vendors. Transmit standardized data to the HCBS Data Management Contractor, including any updates to service records as reported by the EVV vendors. c) Monitoring data files submitted by third-party EVV vendors on an on-going basis to ensure compliance with LDH requirements and providing technical assistance as needed to providers and their third-party EVV vendors. d) Providing service records and any edits to service records to the appropriate Managed Care Organization (MCO).
