The Agency for Health Care Administration is preparing to expand the Comprehensive Care Management (CCM) Project and Telephonic Home Health Service Delivery Monitoring and Verification (DMV) Project that are currently implemented in Miami-Dade County, as a result of legislation passed this past spring by the Florida Legislature.
Effective October 1, 2012, the CCM and DMV Projects will be expanded statewide to counties deemed cost effective and will include all home health services (i.e., home health visits, private duty nursing, and personal care services). See the list of counties and services below.
The CCM Project will include: face-to-face (recipient) assessments by a nurse licensed pursuant to Chapter 464, F.S., consultation with ordering physicians to substantiate medical necessity for services, and on-site or desk reviews of recipients’ medical records. AHCA is currently contracted with eQHealth Solutions, Inc., to implement and manage the expansion of the CCM Project.
The DMV Project telephonically verifies the delivery of home health services. The goals of the DMV Project are to: track the time spent in the home by the nurse or home health aide providing the home health service, verify the home health services occurred as indicated on the recipient’s plan of care and as prior authorized by the Agency’s peer review contractor, (eQHealth Solutions, Inc.), and electronically submit claims on the provider’s behalf for services that have been successfully verified. AHCA is currently contracted with Sandata Technologies, LLC, to implement and manage the expansion of the DMV Project.
To facilitate an efficient and smooth transition, outreach and training sessions will be scheduled prior to implementation. AHCA will continue to provide periodic updates throughout the implementation process via Health Care Provider Alerts and letters.
EXPANSION FOR THE CCM AND DMV PROJECTS
Tags: Agency for Health Care Administration, Comprehensive Care Management Pilot Project, eQHealth Solutions, Sandata Technologies, Telephonic Home Health Services Delivery Monitoring and Verification Project