info_stats ~ Public Information & Statistics – Delaware Health and Social Services – State of Delaware

  • Home
  • info_stats ~ Public Information & Statistics – Delaware Health and Social Services – State of Delaware

Public Information & Statistics

 

Public Information Bulletins

_________________________________________________________________________________

Electronic Visit Verification

ELECTRONIC VISIT VERIFICATION (EVV)

Attention: In-Home Personal Care Service and Home Health Providers

Electronic Visit Verification (EVV) Requirement is Here!

The 21st Century Cures Act requires states to have an EVV system to confirm that certain services paid for by Medicaid are being provided. EVV systems work by requiring the person providing PCS or HHCS to log into an electronic system using a phone, tablet, or other device each time they provide care to a Medicaid member in his/her home.All providers of in-home PCS and HHCS are also required to register with the Sandata provider self-registration portal. Visit the Sandata EVV Provider Self-Registration Portal. You MUST have your Medicaid Provider Identification Number (MCD ID) to register. If you need help with identifying your MCD ID, please contact DMAP Provider Services from 8:00 AM ET to 4:30 PM ET at 1-800-999-3371, select option 0, option 4.Once the registration process is complete, providers may begin accessing the Sandata training resources.

Need Assistance?

  • Please contact the EVV Provider Service Team at DHSS_DMMA_EVV@delaware.gov if you have questions or require more information pertaining to acceptable EVV solutions.
What is Electronic Visit Verification (EVV)? The 21st Century Cures Act requires states have an EVV system to confirm that certain services paid for by Medicaid are being provided. This federal law requires states to have an EVV system in place by January 1, 2020 for Personal Care Services (PCS) and by January 1, 2023 for Home Health Services. The Delaware Division of Medicaid and Medical Assistance (DMMA) is working to implement an EVV system for both services in 2022. EVV systems work by requiring the person providing PCS or Home Health Services to log into an electronic system using a phone, tablet, or other device to confirm the following each time they provide care to a Medicaid member in his/her home. EVV systems can also collect more information than what is required by federal law and can serve as an alert system for missed or late visits, take the place of paper timesheets, and provide access to up to date medical information. For more information about EVV and DMMA’s goals for EVV, please click on the link below. EVV Provider Survey In support of the development and implementation of Delaware’s EVV system, DMMA and DDDS need information from you regarding EVV. All providers as well as financial management service entities who provide services subject to EVV must complete the survey found at the link below. The survey is relatively short and easy to complete. Only one completed survey is needed for each provider. The deadline to complete the survey is May 27, 2022. Questions regarding the survey or general questions regarding EVV implementation may be submitted to DHSS_DMMA_EVV@delaware.gov. Thank you. DE DHSS Provider Electronic Visit Verification (EVV) Survey   Important EVV Announcement The Division of Medicaid and Medical Assistance has postponed implementation of the hard edit for EVV claims until 7.1.25. This means that beginning 7.1.25, claims for services subject to EVV that cannot be matched to a corresponding EVV visit will be denied payment. At present, soft edits are being applied with messages posted on remittance advices (RAs) or communicated directly with providers. DMMA strongly encourages providers to work with the MCOs to correct issues with EVV visits and/or claims during this soft edit period.

EVV Provider Forum – 11/20/24

EVV Provider Forum – 10/02/24

EVV Provider Forum – 07/31/24

EVV Provider Forum – 05/29/24

EVV Provider Forum – 03/27/24

EVV Provider Forum – 02/28/24

EVV Provider Forum – 01/31/24

EVV Provider Forum – 11/29/23

EVV Provider Forum – 10/25/23

EVV Provider Forum – 9/28/23

EVV Provider Forum – 8/30/23

EVV Provider Forum 6/28/23

EVV Provider Forum 5/31/23

EVV Provider Forum 4/26/23

EVV Provider Forum 3/29/23

EVV Provider Forum 2/22/23

EVV Provider Forum 1/25/23

EVV Town Hall 12/30/22

EVV Provider Forum 12/14/22

EVV Provider Forum 11/30/22

EVV Provider Forum 10/26/22

EVV Provider Forum 9/28/22

EVV Provider Forum 8/31/22

EVV Provider Forum 7/27/22

EVV Provider Forum 6/29/22

EVV Provider Forum 5/25/22

EVV Provider Forum 4/27/22

EVV Provider Forum 3/30/22

Comments or Questions: Email: DHSS_DMMA_EVV@delaware.gov Mail: Attention: Diane M. Anton RN III, Nurse Reviewer- SUR Unit Herman M. Holloway, Sr. Campus 1901 N. Dupont Highway New Castle, DE 19720

_________________________________________________________________________________

Medicaid and Justice-Involved Populations

On December 4, 2018, Delaware Governor John Carney signed Executive Order 27. This executive order established The Delaware Correctional Reentry Commission (DCRC) with the objective of effectively coordinating services for the recently released, strengthening data sharing among state agencies, and improving the availability of programming prior to an inmates release in hopes of reducing recidivism. The DCRC must provide a comprehensive report on Delaware’s reentry reforms, practices and policies to the Governor by December 30, 2020. A longstanding Medicaid statute excludes Medicaid payment for services provided to inmates of public institutions, including correctional institutions, except for services provided as “a patient in a medical institution”, such as inpatient hospitalization. However, facilitating enrollment in Medicaid and supporting access to services following incarceration has the potential to make a significant difference in the health of this population and in eligible individuals’ ability to obtain health services that can promote well-being and aide in reducing the rate of recidivism. In June 2018, DMMA, in collaboration with other state agencies, such as the Delaware Division of Mental Health and Substance Abuse, the Division of Social Services, and the Department of Corrections, held the first Justice Involved Individuals Steering Committee meeting, to develop a plan to facilitate access to covered Medicaid services for eligible individuals immediately upon release from a correctional institution. DMMA will also address recommendations received from the The Pew Charitable Trust Final Report-March 2019 Substance Use Disorder Treatment Policy Recommendations for the State of Delaware. For example, the report recommends DMMA, with input from the Department of Corrections, should amend its contracts with managed care organizations to require care management for people with high care needs returning to the community, including individuals with Substance Use Disorders. DMMA continues to meet weekly with other state agencies to develop a path to operationalize this plan and has developed a Delaware Corrections Project Timeline of Events to guide this work. Additional Information The Pew Charitable Trust Substance Use Disorder Treatment Policy Recommendations for the State of Delaware – Final Report- March 2019 Delaware Online Delaware officials eye re-entry help for prison inmates before their release. Executive Order 27 Comments or Questions: Email: DMMA_Publichearing@delaware.gov

_________________________________________________________________________________

Delaware Quality Strategy-DRAFT 2018

The Division of Medicaid and Medical Assistance has reviewed and updated its Quality strategy for assessing and improving the quality of health care and services furnished by the Managed Care Organizations (MCOs). The Quality Strategy includes a framework for the State to communicate the vision, objectives, and monitoring strategies for attaining quality, timely access, and availability of services and cost effectiveness of care. It also provides a description of the quality metrics and performance targets to measure performance improvement of the MCOs and Performance Improvement Projects. This updated Quality Strategy will be submitted to the Centers for Medicare & Medicaid Services (CMS).

_________________________________________________________________________________

Managing the Health Care Needs of Children with Medical Complexity

In compliance with Budget Epilogue Section 141 of the State of Delaware’s Legislature, 149th Generally Assembly’s act making appropriations for the expense of the State Government for the fiscal year ending June 30, 2018; specifying certain procedures, conditions and limitations for the expenditure of such funds; and amending certain pertinent statutory requirements [House Substitute No. 1 (HS1) for House Bill No. 275 (HB275)], Delaware Health and Social Services (DHSS) / Division of Medicaid and Medical Assistance (DMMA) has published a comprehensive plan for children with Medical Complexity.

_________________________________________________________________________________

Mental Health Parity and Addiction Equity Act (MHPAEA)

The Centers for Medicare & Medicaid Services (CMS) issued a final rule that applies the requirements of the Mental Health Parity and Addiction Equity Act (MHPAEA) to Medicaid managed care organizations (MCOs), the Children’s Health Insurance Program (CHIP), and Medicaid alternative benefit plans (ABPs). The rule requires Delaware and its contracted Medicaid/CHIP MCOs to be in compliance with the final parity rule by October 2, 2017. This includes providing documentation of parity compliance to the general public and posting this information to the State’s Medicaid website by October 2, 2017. The purpose of this posting is to provide public notice and receive public input for consideration regarding Delaware’s draft report of compliance with the final rule. For additional information about the CMS final Medicaid/CHIP parity rule, use the following link to the CMS website: https://www.medicaid.gov/medicaid/benefits/bhs/index.html DHSS/DMMA gives public notice and provides an open comment period for thirty (30) days to allow all stakeholders an opportunity to provide input on the final Medicaid/CHIP parity rule. The comment period begins on August 1, 2017 and ends on September 11, 2017.

_________________________________________________________________________________

Diamond State Health Plan & Diamond State Health Plan Plus Managed Care Master Service Agreement

Monthly enrollment totals for Medicaid and CHIP (connects to Delaware Open Data Portal) Diamond State Health Plan, Diamond State Health Plan Plus & Children’s Health Insurance Program: Quality Management Strategy 2015 Promoting Community-Based Alternatives for Medicaid Long-Term Services and Supports for the Elderly and Individuals With Disabilities