Electronic Visit Verification (EVV) Newsletter

Hello and welcome to the Electronic Visit Verification (EVV) Newsletter - a newsletter with timely content on important updates, best practices, and resources to support your EVV experience.

EVV Newsletter Highlights

• Live-in Caregiver (LIC) Panel - Coming Soon!
• Common Issues in Live-In Caregiver Exemption Audits
• Proper Use of the Place of Service 99 for Live-in Caregiver Electronic Visit Verification Exemption Eligible Services

What is EVV?

EVV is a technology used to verify that home and community-based service visits occur. The purpose of EVV is to ensure that services are delivered to people needing those services and that providers bill only for services rendered.

Did you Know?

HCPF pre-approval is required for EVV exemption requests for extenuating circumstances, but HCPF receives at least two times as many requests for general live-in caregiver EVV exemptions. 

Currently, if you are not requesting an extenuating circumstance EVV exemption, documentation should be sent to your provider agency or Financial Management Service vendor. Sending to HCPF is unnecessary for general live-in caregiver EVV exemptions and may result in delays.

What's New with EVV?

Live-in Caregiver Panel - Coming Soon!

The Department of Health Care Policy and Financing (HCPF) will be making updates to the live-in caregiver (LIC) exemption process using the Provider Web Portal. Some highlights of this change include:

• Application requests and Revalidation Applications will be used for LIC exemption submissions and approvals.
• Providers will receive notifications 60 and 30 days before expiration, on the day of expiration, and 30 days after. 
• Strengthens overall exemption process
• Simplifies exemption selection process
• Uses existing Application requests and Revalidation Application processes
• Notifications and reminders
• Provider billing improvements
• Improved and timelier feedback
• Improves HCPF oversight while maintaining LIC flexibilities

See the July 2024 EVV General Stakeholder Meeting presentation or recording for more information.

Remote Support Services Removed from EVV

Remote Supports has moved to a standalone service on Home and Community-Based Services (HCBS) Elderly, Blind, and Disabled (EBD), Supported Living Services (SLS), Brain Injury (BI), Complementary and Integrative Health (CIH), and Community Mental Health Services (CMHS) Waivers as of Aug. 1, 2024, and no longer requires EVV.

Case Management Agency and Remote Supports Provider Training slides, along with recordings of past Meet and Greets with our Providers, are available on the LTSS Training webpage.

Additional details are available within Operational Memo 24-037 Remote Support Services.

For more information or questions regarding Remote Supports, please visit the Remote Supports webpage or contact Kacey.Wardle@state.co.us. 

New Way to Contact Us! - Streamlining EVV Questions and Exemptions using the EVV Inbox Form

Stakeholders of Electronic Visit Verification (EVV) can now utilize the EVV Inbox Form to contact the EVV Team! This new communication tool can be used to submit

• Live-in Caregiver Exemptions - Extenuating Circumstances ONLY
• Policy and Program questions
• Escalations from other support methods

The EVV Team will continue to monitor and use the EVV Inbox, however, this streamlined process ensures that inquiries are managed effectively, enables timely responses, and fosters better communication among stakeholders and HCPF Staff.

For more details or to contact the EVV team using the EVV Inbox Tracker, visit the EVV Contact Us Page.

Reminders

Common Issues in Live-In Caregiver Exemption Audits

In recent audits of live-in caregiver (LIC) exemptions, several recurring issues have been identified across multiple providers and types of services, including:

• Expired LIC Exemptions: Many providers failed to renew their exemptions on time and were found to be billing with an inactive EVV LIC exemption. This is considered improper billing and HCPF is taking action to educate providers on this practice.
• Missing Member Signatures: Documentation often lacked the necessary approvals from the member, caregiver, and/or provider agency.
• Incorrect Identification: Some submissions included the NPI instead of the provider's Medicaid ID.
• Multiple LIC EVV Exemptions Selected: More than one exemption is marked on the LIC exemption form.

Providers are encouraged to review their own documents and update them as needed.

Proper Use of the Place of Service 99 for Live-in Caregiver Electronic Visit Verification Exemption Eligible Services

HCPF review has identified potential issues with EVV-required services being billed with Place of Service (POS) 99, indicating a Live-in Caregiver (LIC) EVV exemption. To address these concerns, please review the following:

• Operational Memo 20-051 - EVV Live-In Caregiver Exemption
• HCPF Billing Manuals 

These resources outline the applicable procedures for billing LIC EVV exemptions and services according to your provider type, helping to avoid billing errors, claim denials, and risk for recoupment.

HCPF strongly encourages all providers to review the applicable billing manual to confirm they are billing using the HCPF-allowed places of service (POS). The specific service types that are ineligible to use the LIC EVV exemption but are allowed to use POS 99 for "Other - community location" are Pediatric Behavioral Therapy (PBT), Occupational Therapy (OT), Physical Therapy (PT), and Speech Therapy (ST). In these cases, these services must have EVV for matching and claims payments.

All other services that are eligible for the LIC EVV exemption and who have previously used POS 99 to indicate information other than Live-in Caregiver designation are advised that this POS was repurposed in May 2020 to identify services provided by Live-in Caregivers. As a reminder, utilizing POS 99 for Live-in Caregiver-exempted services requires completed LIC documentation on file.

Thank you for your prompt attention to this matter and reach out to the EVV inbox with any questions.

Need to Make an Accommodation Request for any of our EVV-related Meetings?

Reasonable accommodations for the meetings will be provided upon request for persons with disabilities. Auxiliary aids and services for individuals with disabilities and language services for individuals whose first language is not English may be provided upon request.

Please contact John Barry at john.r.barry@state.co.us or HCPFs 504/ADA Coordinator at hcpf504ada@state.co.us at least one week prior to the scheduled meeting to make arrangements.