Frequently Asked Questions

The states that had shown good faith effort in implementing EVV before the initial deadline (January 1, 2020) but failed to do so due to unavoidable delays were offered an exemption. These states have been provided a one-year EVV extension under the Good Faith Effort Exemption Request with a new deadline to implement EVV till January 1, 2021.

The objectives of EVV are to ensure that members receive timely service delivery, to reduce the administrative burden associated with paper timesheet processing, and to generate cost savings by preventing fraud, waste, and abuse.

Yes, CareSmartz360 is EVV-compliant home care software that can be used by home care agencies across the United States.

CareSmartz360 can be used as an EVV solution in California. It’s straightforward to switch from an existing EVV-compliant home care software to CareSmartz360.

The EVV deadlines vary for different states. To know about your state EVV or its deadline, click here.

No, you will not incur any ongoing costs for the DSS EVV system. However, if you choose to integrate your current scheduling system into DSS’ EVV system or if you use any third-party EVV solution, you may be required to write additional checks.

No. The EVV system is simple to use, and you may not need to hire any additional staff. Ensure that your caregivers and office staff are fully trained and EVV compliant, and you’ll be fine.

No, you may continue to use your current home care software with a built-in EVV system for Home and Community-Based Services (HCBS).

The 21st Century Cures Act requires states to use EVV for all Medicaid personal care services (PCS) and home health care services (HHCS) that require an in-home visit. This covers PCS provided under sections 1905(a)(24), 1915(c), 1915(i), 1915(j), 1915(k), and Section 1115; and HHCS provided under 1905(a)(7) of the Social Security Act or a waiver.

Yes. Home health agencies that provide the care services mentioned above are subject to the EVV mandate. The claim may be denied if agencies submit a reimbursement claim without corresponding through EVV after January 1, 2021.

Yes, both Consumer Directed Attendant Support Services (CDASS) and In-Home Services and Supports (IHSS) are required to comply with the EVV mandate.

The key technologies used in implementing EVV for capturing visit and care delivery information at the service location through:

Mobile Visit Verification (MVV): A GPS-enabled mobile application downloaded on a smartphone or tablet.

Telephony Visit Verification (TVV): A system accessed via a toll-free number, accessible 24 hours a day, 7 days a week.

Agency Portal: Agencies utilizing the EVV-based solution can access the information to view and modify visit activity and, in limited circumstances, create EVV records. The data entered via the agency portal is notated as a manual entry and will be subject to a department audit.

Data Aggregator: The data aggregator is a solution provider to interface with the state EVV solution and provider choice systems to transmit EVV data. Providers will have read-only access to a web portal in the Data Aggregator to view visit data.

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.

CMS does not consider the EVV requirement to be applicable to PACE program services. PACE, according to CMS, is a separate Medicaid benefit listed in section 1905(a)(26) of the Social Security Act, which is not cited in section 12006(a)(5)(C) of the Cures Act.

All services requiring an in-home visit and included in claims on the CMS-64 form under the home health or personal care services category 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 or home health services, even if it has a different name or includes additional services, it is subject to EVV.

Section 1903(l)(5)(A) provides that the system must be able to verify electronically, concerning visits conducted as part of personal care services or home health care services, the following:

  • Which type of service was performed
  • Who is the individual receiving the service
  • What is the date of the service being provided
  • What is the location of service delivery
  • Who is the person providing the service
  • At what time the service begins and ends

Section 1903(l)(2) also requires states to provide a stakeholder process to allow input into the state’s implementation of the EVV requirement from PCS and home health services providers, beneficiaries, family caregivers, and other stakeholders.

No. There is no mandate for that. States have significant discretion in choosing the EVV system as per their needs. However, it should collect all of the statutorily mandated information on personal care and home health care services that require an in-home visit by a care provider. The Centers for Medicare & Medicaid Services (CMS) does not endorse or recommend any specific type of EVV system.

The following is a high-level summary of anticipated changes with the implementation of EVV:

Things that will not change:

  • Member choice of provider
  • Availability of services
  • Member choice of individual direct care worker
  • How services are provided
  • Where services are provided

Things that will change:

  • Elimination of paper timesheets
  • Use of EVV devices
  • How member/representative signature is collected
  • Member/representative requires verification at the end of every visit/shift

21st Century Cures Act’s timelines for State implementation of the EVV requirements are as follows:

  • Personal Care: January 1, 2021
  • Home Health Care: January 1, 2023

  • Phase I – Target January 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 January 1, 2023
    • 1905(a)(7) State Plan Home Health Services
    • Home Health Services authorized under a waiver of the plan

The 21st Century Cures Act requires EVV for all home care agencies to keep the ball rolling for claiming Medicaid bills. If the agency owners do not comply, they will be entitled to 1% of their FMAP deductions.

There are specific standards brought into force by the Senior and Disabilities Services (SDS) to ensure that the care services are delivered only by individuals who possess the requisite skills and competencies and to ensure that services are performed safely and effectively.

Other regulations that care providers must comply with are:

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

CareSmartz360 offers a robust billing solution for smart and accurate billing, adequate payment, and quick reporting. Care providers can submit claims the same day they offer services and get paid faster to stay ahead of claim denials.

Additionally, CareSmartz360 is all-inclusive of electronic visit verification for agencies who bill Medicaid, captures data required for EVV, and helps keep caregivers focused on care delivery.

Yes, you can use an EVV solution from any third-party provider if it meets all of the state’s EVV aggregator requirements.

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

EVV verifies employee locations, hours of work for payroll and billing, the accuracy of reported visits, and patient care. Better care delivery, gapless communications, enhanced staff productivity, and automation of critical processes are other benefits of implementing EVV. It also helps to curb fraud and ensure transparency in care quality with continuous tracking and monitoring.

Numerous home care software solutions today are integrated with features and functionalities to ensure compliance and contribute to the best possible care delivery. A primary aspect is to look for the one that is easy to use by the staff, caregivers, patients, agency owners, and patient’s family.

The bottom line is that whatever EVV-based solution your agency chooses must precisely document the occurrence of a visit, ensuring that caregivers provided the expected services, allowing for timely and accurate documentation of the activities performed, and ensuring compliance.

By digitizing visit documentation, an electronic visit verification system aims to eliminate the need for manually managing paper timesheets. This will also help eliminate caregivers’ need to submit paper timesheets to agencies.

Yes, even after EVV is activated, your agency will be the billing provider. The caregiver will not directly bill Medicaid. All claims will continue to be required to be billed by the agency.

To begin using a new EVV system, you must first educate yourself on the most recent state EVV requirements. You can choose between the State EVV Solution and a third-party EVV solution. Before implementation, you must also complete mandatory training.

English remains the most common one. Other options are Spanish, Russian, Egyptian, Arabic, Mandarin, and Somali.

No, the client is not required to have a landline or a cell phone. The home care agency is responsible for EVV service verification. A caregiver should be given the EVV technology to punch in the visits and provide the necessary care. A client may give their caregiver permission to use their personal landline or cell phone for EVV, but this is not required.

Yes. The use of EVV does not alter the format or location of service delivery. Patients will continue to receive services per their service plan and the existing program rules.

The State EVV Solution is designed to work anywhere across the state. To facilitate uninterrupted care delivery, the MVV application used by a caregiver can also work without network connectivity. It can upload information when service is restored or connected to Wi-Fi. Alternatively, a TVV option is available in rural areas when a cell phone or landline is available. When MVV and TVV are unavailable, a provider may complete EVV requirements through the provider portal. Please note that manual entries are subject to increased scrutiny by the Department.

Each clock-in and clock-out for MVV in the State EVV Solution uses roughly the same amount of data as a text message.

Clocking-in and clocking-out for MVV and TVV within the State EVV Solution would require less than a minute of caregiver time.

For iPhone: iPhone 6 and higher, running Minimum iOS version 9.0.
For Android: An Android device using Android OS 7.0 (Nougat) or higher, with a minimum OS of Android 5.0 (Lollipop).

The caregiver is responsible for reporting the visit. The visit can be saved once the phone regains power. If the visit is not properly recorded, the agency administrator can correct the visit data in the provider portal. Please remember that manually entered visits are subject to audit by the Department.

Service delivery should not be affected in such a situation. The agency can do a manual entry through the web portal or the software solution. EVV data will always remain encrypted in the lost device.

The EVV system can record multiple visits to a client per day. Each caregiver has their own unique identifier, and EVV records created by that identifier are caregiver-specific. The EVV solution does not limit the number of services a client can receive in one day.

Home care providers may choose to implement and utilize the EVV system. A provider-choice EVV system must meet Cures Act requirements and integrate with the State EVV Solution for data transfer. While providers may utilize the State EVV Solution free of charge, costs associated with purchasing and maintaining a provider choice system are the provider’s responsibility. There will be no fee to providers for connecting or transmitting data to the State EVV Solution.

If a provider choice system cannot interface with the Data Aggregator, no EVV information will be transmitted. Thus, providers cannot verify their EVV data submissions through the State EVV Solution web portal.

The hybrid approach to EVV implementation permits flexibility when choosing which system to utilize. Home care agencies may use the State EVV Solution at any time. Since training and systems requirements for the State EVV Solution may differ from provider choice systems, the Department recommends that providers plan timelines accordingly to ensure a seamless transition.

A train-the-trainer training model will be provided to the agencies and their staff through the Department’s EVV vendor. If going with a third-party EVV solution company, the training will be imparted by them.

The EVV training is mandatory for State EVV Solution users and provider-choice EVV users. Human errors and the failure to record crucial information may result in the denial of claims.

There is a scheduling module within the EVV system. DSS has also selected the option to integrate third-party schedule solutions with EVV. Home care software solutions are integrated with advanced capabilities that can automate the matching and scheduling of caregivers per the client’s needs.

During the EVV implementation stage, the agency will be provided detailed instructions on setting up each caregiver in the EVV system and providing them with unique IDs used for visit verification. The EVV system will know and use each caregiver’s unique ID and information to verify who they are when they record visit information.

Yes, the cloud-based EVV system allows the agency to fix visits that do not have all the required information. For instance, a caregiver who forgot to record the visit’s start or end time.

Whenever a care plan changes, the EVV system will send an alert with a pop-up message to the caregiver.

The ‘right caregiver type’ refers to delivering critical care by the appropriate caregiver. Service is provided only by an authorized and licensed caregiver.

Ideally, in such a situation, the caregiver should capture the start and end times as they transition between care activities.

A unique user ID and password secure the EVV system. Agency administrators are responsible for generating unique login credentials for all caregivers. It is the provider’s job to maintain the confidentiality of that information.

The technology used in the EVV system to verify the caregiver’s location will only record locations at the start and end of the care delivery. For any other time, it does not record anything.

New-age home care software is built on technologies with offline functioning capabilities. When the connectivity resumes, it syncs the data with the system.

  • Improved service accountability.
  • Reduced billing errors and claim denial rates.
  • Reduced manual processes and use of paper due to streamlined automation.
  • Streamlined communications between provider office and caregivers.
  • Service dashboard with reporting capabilities.
  • Search, select, assign, and schedule a caregiver easily.

Yes, as per the 21st Century CURES Act, a caregiving agency must implement EVV for claiming Medicaid. Every agency needs to implement EVV before January 1, 2021.

EVV (Electronic Visit Verification) is a system that records the punch-in and punch-out timings of caregivers to minimize Medicaid fraud.

Yes, EVV is a GPS-based system that provides real-time updates of the caregiver’s location.

Yes, EVV is mandatory in every state of the US.

The EVV system you choose must be HIPAA compliant. You need to verify the same before choosing one for your agency.

Electronic Visit Verification (EVV) is a system that tracks the caregiver and maintains digital records for the punch-in and punch-out of the caregiver at the destination. This data is utilized for claiming Medicaid by the caregiver agency.

You don’t need to worry about meeting the EVV requirements. As a caregiver agency, you must consider relying on home care management software with EVV, which must be HIPAA-compliant.

Caregivers can get maximum benefits from EVV-based home care management software. They get paid for the extra hours spent during the shift. Plus, they save ample time that otherwise gets squandered in maintaining paperwork.

No, it would be best to choose any third-party EVV software compliant with the state’s regulations. However, there could be annual software maintenance charges, which also vary according to the service provider’s policies.

EVV affects both medical and non-medical home care services. The caregiving agencies need to be compliant to claim Medicaid.

Yes, private-duty, non-medical caregiver agencies must implement EVV.

Yes, EVV would recognize a caregiver with a unique identity. A unique identity for the caregiver prevents the disclosure of personal information.

There are several EVV software solutions available. Yet CareSmartz360 is one of the best home care management software with EVV!

Home care services can use EVV software to track clock-in and clock-out times. It is critical for long-term insurance claims and state reimbursement to be successful. Many states also require this as part of the legal compliance process. The Electronic Visit Verification software allows for detailed logging of hours, which aids in quick and accurate billing and invoicing.

Yes, EVV is implemented through a mobile-based application. Any similar device, such as a tablet, could also run the EVV application.

Yes, most of the home care management software provides adequate scheduling information that the caregiver agency can alter, and the caregiver could request changing shifts.

Yes, the client can access information related to the caregiver’s schedule and visits.

Yes, a unique identification number would be provided to each caregiver to help track caregivers from different agencies.

The manual approach would be considered, just in case the EVV system isn’t working. The agency needs to look into the matter in such instances.

The vendor, who provides an EVV suite, typically offers adequate training to the caregiver and the agency.

To find out which services rendered by your home care agency will be affected by this mandate, please click on the EVV Service List link for all the updated EVV-mandated services and optional EVV services.

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