Newsletter Vol. 31, No.16

REQUIREMENTS: 1. By July 1, 2021: Billing team and providers must complete one-time EVV compliance attestation at https://www.cognitoforms.com/HHAeXchange1/njevvproviderattestationform. Document current status (Operational, Engaged, or Disengaged) and reason for any non-compliance with all applicable payers (FFS Medicaid, Aetna, Amerigroup, Horizon, UnitedHealthcare, WellCare). 2. By September 1, 2021: Billing team must ensure PCA billing workflow is fully integrated with correct EVV system per payer: HHAeXchange for FFS Medicaid/Aetna/UnitedHealthcare/WellCare OR CareBridge for Amerigroup/Horizon. All EVV-mandated PCA services must be submitted and billed through designated platform. Update billing software to route claims to correct portal by payer. 3. By September 30, 2021: Providers must achieve Operational status with all payers or lose ability to bill for services delivered after this date. Disengaged providers must move to Engaged status immediately to avoid case transition starting August 1, 2021 (FFS Medicaid) or September 1, 2021 (DDD). 4. Immediately: Establish communication with assigned payer contacts (listed in policy table) to confirm EVV integration requirements and troubleshoot any technical issues with HHAeXchange or CareBridge. 5. Ongoing through October 1, 2021: Monitor case transitions for any existing PCA members being moved to Operational providers. Ensure continuity of care documentation is transferred. CONSEQUENCES: Failure to achieve Operational status results in: (1) No new PCA referrals as of July 15-September 1, 2021 depending on status tier; (2) Existing patient cases transferred to compliant providers starting August 1-September 1, 2021; (3) Inability to bill for services after September 30, 2021 until full compliance achieved; (4) Loss of Medicaid/NJ FamilyCare provider participation.