Electronic Visit Verification
Section 12006(a) of the 21st Century Cures Act mandates that states implement Electronic Visit Verification (EVV) for all Medicaid Personal Care Services and Home Health Services that require an in-home visit by a provider. This also applies to similar services delivered under Home and Community-Based Services waiver programs.
The Cures Act, passed in December 2016, requires all state Medicaid agencies to implement an EVV requirement for providers of Personal Care Services (PCS) and Home Health Services (HHS) to avoid a reduction in federal Medicaid funding.
What is EVV?
EVV is a system that includes multiple point-of-care verification technologies, such as telephonic, mobile, and web-based verification inputs. The system electronically verifies the occurrence of home or community-based service visits, identifying the precise time that service provision begins and ends to ensure accurate claims disbursement.
EVV is required for all Personal Care Services and Home Health Services under Medicaid effective July 1, 2019*. Providers must select their own EVV service vendor and have records available for review upon request. All systems must be compliant with the Cures Act requirements including:
- the type of service performed
- the individual receiving the service
- the date of the service
- the location of service delivery
- the individual providing the service
- the time the service begins and ends
- the date of creation of the electronic record
Providers may choose the EVV system that best meets their needs and are not required to use a specific software or vendor as along as the system meets federal requirements.
*While a July 1, 2019 compliance date has been set, recoupment/penalties for not having EVV data will not take place until January 1, 2021 for PCS and January 1, 2023 for HHS.