September 30, 2020
Livanta Requirement: What to Do if You Don’t Have Direct
Secure Messaging. Starting tomorrow, October 1, the direct secure
messaging requirement from Livanta takes effect. The short notice of the
requirement left many OHCA members scrambling. If you reached out to your electronic medical record (EMR) vendor, you likely
were told that implementing direct secure messaging requires a waiting period. If your EMR does
not support direct secure messaging, Livanta provided OHCA with a list of Health Information Service Providers (HISPs) that can facilitate direct secure messaging. Please contact Erin Begin
if you would like to review the list.
OHCA also obtained the following clarifications
to help members meet Livanta's requirement until direct secure messaging
connections are made, and after:
The waiver:
If you received Livanta's notice last night, you likely know there is
an option to obtain a waiver allowing you to delay implementing the
electronic
documentation submission requirement. This option is a bit misleading.
For
one, the waiver is not yet available (it will be posted here
once available).
Secondly, the waiver is only valid through December 31, 2020.
Additionally, the waiver must be approved under the following criteria:
a. The
provider can show it lacks an electronic medical record system capable of
securely transmitting electronic records to Livanta; and
b. The
organization signs a memorandum of agreement (MOA) with Livanta if
required to do so. Click here for more information on MOAs.
Livanta will process waivers
on a case-by-case basis, so if you are looking for a quick fix, this is not
your best option.
Livanta File Transfer Portal: Under this option, providers submit medical records through the e-LiFT portal. Before uploading a medical record, the provider must enter the case number and a
unique identifier supplied on the medical record request. Accepted file types
include PDF. OHCA is awaiting clarification on limitations related to the
file size and number of attachments allowed for each submission.
While provider submissions are required electronically, the
request for medical records from Livanta will still be sent through fax.
Here are a couple additional details regarding electronic submissions:
Direct Secure Messaging: If you
already have direct secure messaging through your EMR or another vendor, you
can send the medical records to QIOAppeals@Direct.Livanta.com
for discharge and service termination appeals and QIOQuality@Direct.Livanta.com
for quality of care complaints.
Reimbursement:
If you submit medical records electronically (either through direct
secure messaging or the e-LiFT portal), Livanta will reimburse you at a
flat rate of $3.00 per patient record in the next billing cycle. A
patient record is defined as “all patient care data and other pertinent
data or information relating to care or services provided to an
individual patient in the possession of the provider or practitioner, as
requested by a QIO for the purpose of performing one or more QIO
functions.” Additionally, duplicate copies or fragmented submissions
for one episode of care will not be reimbursed individually. Only
providers will be paid, and invoices will not be acknowledged. For
additional information on reimbursement, please see the Livanta Postage and Pages Reimbursement Protocols webpage.Unpublished CMS SNF Testing Change Disrupts Ohio Schedule. It is our understanding from a state source that yesterday, when the Centers for Medicare and Medicaid Services (CMS) announced
changes made two weeks ago to the formula it uses to assign county
positivity ratings, CMS also changed the impact on testing frequency
when a county moves from a higher to a lower positivity level. According
to Quality, Safety, and Oversight letter (QSO) 20-38-NH,
SNFs in such a county must continue to conduct routine staff testing at
the higher frequency for 14 days after the color changes. We are told
that CMS removed that requirement, allowing providers to apply the lower
frequency - although the announcement does not state this clearly. The
only clue is in the positivity spreadsheet itself, where after explaining the calculation changes, CMS wrote, "[n]ursing homes may set their testing frequency based on the color-coded reassigned positivity classification."
As
a result of this change, the state is redoing their state-supported
testing schedule for next week to account for counties that moved to
lower positivity ratings: "I wanted to inform all
of you that given some changes made by CMS and the county positivity
ratings the schedule for Nursing Home testing will be released tomorrow;
however, testing will still occur beginning 10/5/2020."
ODH Lab Portal News. Although
we have not seen an Enhanced Information Dissemination and Collection
System (EIDC) notice on it, we believe that a production version of
changes to the ODH lab portal for SNF testing will go into production
tomorrow and will be available for your use. These changes respond to
widespread concerns about the need continually to reenter data into the
portal for each round of testing. If you gain access to the portal
tomorrow, please be sure to check the revised testing schedule discussed
above. Some centers will test on different days than expected because
of the change.
Error in Eye Protection Piece. In last night's COVID-19 Update,
we erroneously identified the color of the counties where Department
of Health (ODH) surveyors expect SNF staff to wear eye protection (face
shield or goggles). It is orange,
red, and purple, not yellow. As a side note, the relevant Centers for
Disease Control and Prevention (CDC) guidelines specify that staff
should "[w]ear eye protection in addition to their facemask to ensure
the eyes, nose, and mouth are all protected from exposure to
respiratory secretions during patient care encounters." The words
"during direct patient care encounters" show that eye protection is
required while providing care, not anywhere in the facility.
PAWS Reinstatement, Risk/Benefit Guide.
Today, the Department of Developmental Disabilities’ (DODD's) Debbie
Hoffine announced that the department will reinstate Prior Authorization
of Waiver Services (PAWS) edits for claims processing in early November
(expected date of November 5). While DODD
removed the edit during the pandemic, providers still were required to
receive county board authorization for the services they provide (via
email, phone call, etc.). While DODD does not require county boards to
reconcile authorizations with claims billed for dates of service before
the edit is reinstated, some county boards are doing so. Providers
should work with their county board(s) to determine what actions will be
required as the PAWS edits return.
In addition, DODD’s Kim Hauck clarified that their revised risk/benefit discussion guide applies
not only to planning related to ICF resident outings but also replaces
the previous version used to help decide whether to return to adult day
services (for both ICF and waiver recipients).
FREE Leadership Coaching for DD Providers.
OHCA partnered with other DD organizations to provide free leadership
coaching webinars for our DD provider members. The sessions will be led
by consultant Jason Barger and will take place over three Thursdays
(October 15, November 12, and December 17) from 4:00-5:00 p.m. OHCA
recognizes that many leaders in DD services have had more asked from
them now during the COVID-19 pandemic than any other time during their
careers. These free leadership coaching forums will support DD leaders
in navigating through change. For more information and to register for
these FREE webinars, please see the educational brochure.