The Missouri Medicaid Audit and Compliance Unit (MMAC) has been advised that some Personal Care Services (PCS) providers have not registered with the Electronic Visit Verification (EVV) Aggregator Solution (EAS), hosted by Sandata Technologies. All PCS providers that currently have Medicaid participants authorized to receive PCS services are required to register their EVV vendor with EAS using this link: Missouri DSS EAS (EVV Aggregator Solution): Provider Online EVV Vendor Registration (office.com)
To register with EAS, you will need your nine-digit MO HealthNet provider ID number(s). This number is not your NPI, IRS Employer Identification Number (EIN), MO DOR EIN, or Social Services Block Grant (SSBG) number on your PCS contracts. Some providers may have more than one MO HealthNet provider ID number, depending on whether you provide state plan In-Home Personal Care and Consumer Directed Services (CDS) and whether you enrolled with more than one legal entity using different IRS EINs. If you do not know your assigned MO HealthNet provider ID number(s), you can request that information by sending an email with your NPI number(s) to MMAC.EVV@dss.mo.gov.
PCS providers that are enrolled with MO HealthNet, but don’t currently have any participants authorized by the Missouri Department of Health and Senior Services (DHSS) or the Missouri Department of Mental Health (DMH) are not required to register with EAS until such time as they contract with an EVV vendor and begin providing PCS services.
If you have questions or need assistance with the online EVV provider registration, contact Sandata Technologies at MOAltEVV@Sandata.com
MO HealthNet has posted a lot of useful information for PCS providers about EVV requirements, including detailed Frequently Asked Questions (FAQs) on their website at https://dss.mo.gov/mhd/providers/electronic-visit-verification.htm
Providers can also submit EVV questions to MO HealthNet as ASK.EVV@dss.mo.gov
The DHSS Division of Senior and Disability Services (DSDS) has posted EVV information on their website at https://health.mo.gov/seniors/hcbs/
The Centers for Medicare & Medicaid Services (CMS), in partnership with the States, is measuring improper payments in the Medicaid and Children’s Health Insurance Program (CHIP) programs under their Payment Error Rate Measurement (PERM) process.
CMS and its PERM contractors will be sending records requests directly to Missouri Medicaid/CHIP providers for claims billed during state fiscal year 2021. Additional information about the PERM program is addressed on the CMS PERM website (https://www.cms.gov/PERM). Refer to the “Providers” link on the website.
Federal regulations require that Medicaid/CHIP providers submit the medical record documentation to support claims for Medicaid/CHIP services to CMS upon request. Providing medical records for Medicaid/CHIP patients does not violate the Health Insurance Portability and Accountability Act (HIPAA). Patient authorization is not required to respond to this request. CMS and its contractors will comply with the Privacy Act federal regulations governing the sharing and transmission of Protected Health Information (PHI).
Please refer to the PERM sample letter and to the PERM Provider Frequently Asked Questions document for more information.
Questions regarding the PERM audit may also be directed to the State PERM representative Joyce Chandler at 573-751-7993 or please email MMAC.PERMAUDITS@DSS.MO.GOV.
The Missouri Medicaid Audit and Compliance Unit (MMAC) has been made aware that some HCBS providers have not been conducting FCSR checks on new employees/personal care attendants, under a mistaken assumption it was not required during the declared COVID health emergency. The Missouri Department of Health and Senior Services (DHSS), Division of Senior and Disability Services (DSDS) did grant limited flexibility on their COVID-19 Flexibility Authority Chart to “Suspend requirements for background and Good Cause Waiver to be returned prior to aides providing care”. That flexibility did not mean that FCSR checks didn’t have to be initiated before the individuals had their first contact with Medicaid participants.
On the DSDS webpage for COVID-19 HCBS Provider Information, DSDS guidance that has been in place since March 2020 states:
Family Care Safety Registry (FCSR)
The state will waive the requirement for the FCSR background check to be returned prior to the start of the individual providing care as it is anticipated there may be a delay in background check processing. The provider shall file the FCSR request prior to the aide providing care, and the aide/attendant may begin providing care immediately. If a potential aide/attendant requires a Good Cause Waiver, the state will waive the requirement for the waiver to be returned prior to the individual providing care. Providers shall only make this exception for crimes that are typically waived with the Good Cause Waiver.
HCBS providers that have not conducted FCSR checks on employees/personal care attendants that were hired since the beginning of the COVID-19 health emergency should do so immediately. Providers with questions may contact LTSS@health.mo.gov or MMACProviderReview@dss.mo.gov
