Electronic Visit Verification (EVV)
A State-by-State Guide

Section 12006 of the 21St Century Cures Act (the Cures Act), P.L. 114-255, added Section 1903(l) of the Social Security Act (SSA). Section 1903(l) provides that states must require the use of an electronic visit verification (EVV) system for personal care services (PCS) and home health care services (HHCS) that require an in-home visit by a provider.

• Phase I – Target Jan. 1, 2019
  
  • 1905(a)(24) State Plan Personal Care
  • 1915(c) HCBS Waivers
  • 1915(i) HCBS State Plan
  • 1915(j) Self-directed Personal Attendant Care Services
  • 1915(k) Community First Choice State Plan
  • 1115 Demonstration Waiver
• Phase II – Target Jan. 1, 2023
  
  • 1905(a)(7) State Plan Home Health Services
  • Home Health Services authorized under a waiver of the plan

There are certain standards brought in force by the Senior and Disabilities Services (SDS) to make sure that the care services are delivered only by individuals who possess the requisite skills and competencies and to ensure that services are performed in a safe and effective manner.

Other regulations with which care providers must comply:

• Medicaid regulations
• HIPAA (Health Insurance Portability and Accountability Act of 1996)
• HIPAA Title II Administrative Simplification and Compliance Act
• Civil Rights Act of 1964
• Section 504 of the Rehabilitations Act of 1973
• Age Discrimination Act of 1975
• Americans with Disabilities Act of 1990
• Occupational Safety and Health Act of 1970

Ideally, a home care software is embedded with functionalities to help home care service providers meet all the regulations and stay compliant for every relevant act.

An annual provider fee to support the Statewide EVV system is under consideration. Home care agencies who are using EVV-based software solution as per the State’s technical specifications and are approved as EVV vendors can continue to use their EVV systems.

Under the new mandate, the EVV system must verify the following:

• Date of service
• Location of service
• Individual providing service
• Type of service
• Individual receiving service
• Time the service begins and ends

A number of home care software solutions are available in the market today that are integrated with features and functionalities to adhere to all the compliance and contribute in the best possible care delivery. A basic criteria to look for is a platform that is easy to use by your staff, caregivers, patients, agency owners and patient’s family.
The bottom line is that whatever EVV-based solution your agency chooses, it must document precisely that a visit took place, ensuring that caregivers provided the expected services, allowing for timely and accurate documentation of the activities performed, and ensuring compliance.