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04/19/2018

Important New EVV Updates

Legal Impact on HIPPAA | EVV Lab | Implementation and Rule Delay | Changes to Edits

Over the past year, OCHCH has been advocating for changes to improve Ohio’s Electronic Visit Verification (EVV) system as well as providing our members the tools they need to come into compliance with this new federal mandate.

Based in large part to OCHCH’s efforts, we’re excited to announce some key updates and new changes to the EVV system, including:

  • Legal update on how EVV impacts HIPPA
  • Implementation and Rule Delay
  • Changes to EVV edits

Legal Update on How EVV Impacts HIPPA

During the first EVV Summit in December, OCHCH members asked the association to get an independent legal opinion on how EVV could impact home health agencies. The concern was that EVV would require agencies to provide front-line staff with new forms of Protected Health Information (PHI) in order for the system to work, thus creating greater exposure to a HIPPA violation or breach.

As a result, OCHCH worked with a HIPPA attorney from Bricker & Eckler in Columbus to determine the level of risk EVV poses to home health agencies due to the new PHI needs. The attorney concluded that ODM is within their authority to require the use of PHI—in this case PHI being the Medicaid ID. There is nothing we can do to challenge ODM’s requirement to use the Medicaid ID. However, the attorney also believes this requirement puts agencies at greater risk of a HIPAA violation or breach than they were prior to EVV. The good news is that we are able to address this issue.

Agencies are already required to use reasonable policies to protect PHI, and as long as those policies exist, agencies are protected from government action. As such, if an agency’s HIPAA policy is updated to address the new EVV risk, then they will be protected even if an employee violates the policy. Agencies will still be required to report a breach, but with an updated policy agencies should have no more liability with Medicaid ID and EVV than they do today.

OCHCH has created guidance explaining the issue in more detail and giving direction as to how agencies can protect themselves from issues with EVV due to EVV. Download the memo, Electronic Visit Verification and HIPAA: What Providers Need to Know.


 EVV Implementation and Rule Delay

On Wednesday, April 18, ODM announced that they are delaying and changing the implementation for EVV, including EVV rule changes. Originally, ODM had expected a “hard” implementation by turning-on the billing component of EVV on July 1—meaning that agencies claims would begin being impacted by their EVV utilization. Based in large part on OCHCH’s advocacy efforts, ODM has agreed to delay the implementation to August 1 and instead will use a “soft” implementation.

Beginning August 1, ODM will use a “pay and post” implementation process in which claims will be paid even if there are inconsistencies with the EVV data. Providers will need to be using EVV by August, but claims won’t be denied. Instead, ODM will post edit information detailing any inconsistencies that exist if the claim wouldn’t have been paid during live billing. It’s not clear when live billing will eventually go-live, but the new soft implementations approach will give providers more time to perfect their EVV processes.

ODM also announced they will delay changes to the EVV rule until later in the year. ODM recently made a couple of changes to the current EVV rule that eliminated the 90-day exception and included details on the Sandata smart phone app, but they’ve decided to wait to make any more changes to the rule until other issues are addressed, including the details of bringing other population on-line with EVV.


Changes to EVV Edits

ODM also announced that in addition to reducing the list of exception codes, ODM is also turning-off the GPS exceptions all together. While providers will still be required to use GPS technology as part of their EVV component, providers will no longer be required to clear an exception relating specifically to GPS.

It’s not clear if ODM will turn-on the GPS exceptions codes again in the future. At least for the time being, this change will reduce the agency exception requirement, which is a positive development.


OCHCH will continue to engage ODM and keep you updated on developments related to EVV. If you have any questions, please contact OCHCH Policy & Advocacy Director Andrew Yogmour at Andrew@ochch.org or 614-885-0434, ext. 208.

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