Sept. 25, 2020: In compliance with Section 12006 of the 21St Century Cures Act (the Cures Act), P.L. 114-255, added Section 1903(l) of the Social Security Act (SSA). Section 1903(l) that requires the use of an electronic visit verification (EVV) system for personal care services (PCS) and home health care services (HHCS) that require an in-home visit by a provider for states participating in the Medicaid program. Programs subject to the EVV requirement are: State Plan Personal Care (PCS) [In-Home], CAP/DA, CAP/C, Self-directed Personal Attendant Care Services, Innovations Waiver, TBI Waiver, and the 1115 Managed Care Demonstration Waiver.
Electronic Visit Verification (EVV) is a method used to verify visit activity for services delivered as part of home- and community-based service programs. EVV offers a measure of accountability to help ensure that individuals who are authorized to receive services in fact receive them, NC will implement EVV effective Jan. 1, 2021. NC DHHS awarded a contract on September 24, 2020 to Sandata Technologies, LLC to be the state’s EVV vendor.
The Department will provide additional information in the coming weeks regarding the onboarding of Sandata, and dates and times of provider and beneficiary training. Medicaid will host Webinars in the next two weeks to provide the details of the implementation plan for each of the affected program groups. Our process will ensure that Medicaid LTSS continues without disruption to our providers and beneficiaries.
On April 24, 2020, the Department of Health and Human Services, Division of Health Benefits (Department) cancelled award of the Comprehensive Independent Assessment Entity (CIAE) Services contract to Keystone Peer Review Organization, Inc. (KEPRO).
The contract was awarded to KEPRO on Jan. 30, 2020. On Feb. 28, 2020, Liberty Healthcare Corporation (Liberty) protested award of CIAE RFP #30-190367-DHB to KERPO. The Department held a protest meeting with Liberty on April 16, 2020. Following the protest meeting, the Department cancelled the award pursuant to Section II.B.6.b of the RFP.
The Department is in the process of extending existing contracts for independent assessments and has not yet determined the timeframe for issuing a new RFP for CIAE services.
On Jan. 30, 2020, NCDHHS awarded Keystone Peer Review Organization, Inc. (KEPRO) the contract for Comprehensive Independent Assessment Entity (CIAE) services. KEPRO was selected based on a thorough and fair evaluation of responses submitted to the Request for Proposal released by the Department in March 2019. Due to a protest filed by the incumbent vendor, the State has voluntarily agreed to stay movement to the new CIAE vendor until a date after the protest meeting is held and a decision on the protest is made by the Department.
NC Medicaid is evaluating the delayed implementation plan, and its impact on PCS, CAP/C and CAP/DA programs to help identify mitigation strategies for the programs during the interim. NC Medicaid will engage affected providers on those mitigation strategies. More information is anticipated by mid-April. PCS, CAP/C and CAP/DA providers should continue to conduct business as usual until further notice.
Please continue to send all PCS Requests for Services to Liberty Healthcare of North Carolina until further notice.
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