EVV Model: Provider Choice Model | Implementation Deadline: January, 2020
You can use CareSmartz360 as your agency management system to meet all EVV state requirements
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.
Governing Body: Not Available
EVV is still to be implemented in most of the states with different guidelines and regulations. We’re keeping up with the updates related to EVV implementation and if there is something we haven’t included, please share with us. To learn how CareSmartz360 can help in ensuring compliance, please get in touch with us.
Centers for Medicare & Medicaid Services does not interpret the EVV requirement to apply to PACE program services. In CMS’s view, PACE is a separate Medicaid benefit listed at section 1905(a)(26) of the Social Security Act, and that provision is not cited in section 12006(a)(5)(C) of the Cures Act.
All services requiring an in-home visit that are included in claims under the home health category or personal care services category on the CMS-64 form are subject to the EVV requirement. In addition, services furnished under waivers or demonstration projects that meet the statutory or regulatory definition of a “home health service” or “personal care service” must meet the EVV requirement, even if they are bundled into a different service or furnished through a managed care provider. In other words, if the service includes personal care services or home health services, even if it has a different name or also includes other services, it is subject to EVV.
Section 1903(l)(5)(A) provides that the system must be able to electronically verify, with respect to visits conducted as part of personal care services or home health care services, the following:
Section 1903(l)(2) also requires states to provide for a stakeholder process to allow input into the state’s implementation of the EVV requirement from providers of PCS and home health services, beneficiaries, family caregivers and other stakeholders.
No. As long as all of the statutorily mandated information is collected on personal care and home health care services requiring an in-home visit by a provider, states have significant discretion to utilize the system(s) of their choosing. Centers for Medicare & Medicaid Services (CMS) does not endorse one type of system over another.
The following is a high level summary of anticipated changes with the implementation of EVV:
|Things that will not change||Things that will change|
|Member choice of provider||Elimination of paper timesheets|
|Availability of services||Use of EVV devices|
|Member choice of individual direct care worker||How member/representative signature is collected|
|How services are provided||Verification is required by member/representative at the end of every visit/shift|
|Where services are provided|
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