Frequently Asked Questions

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

CareSmartz360 offers EVV compliance in Ohio. It also helps agencies in streamlining business operations and enhance revenues.

Yes, CareSmartz360 is EVV compliant and can be used by home care agencies serving in different states of the United States.

No, the CareSmartz360 home care management software comes with an embedded electronic visit verification system that offers Medicaid compliance.

You need to get CareSmartz360 home care management software that provides you Medicaid.

No, you do not have to bear any continuous cost for the DSS EVV system. However, if you choose to integrate your current scheduling system into DSS’ EVV system, or any other third-party EVV-based solution then you may have to write the checks for additional payments.

No. Using EVV system is easy, and you may not have to recruit any extra staff. Keep in mind that your caregivers and office staff are fully trained and compliant with EVV.

No, you may use your existing home care software, with its built-in EVV system, for HCBS services.

Behavioral Services (provided in the home) Consumer Directed Attendant Support Services (CDASS) Durable Medical Equipment (requiring in-home setup) Home Health Homemaker Hospice Independent Living Skills Training (ILST) In-Home Respite In-Home Support Services (IHSS) Occupational Therapy (provided in the home) Physical Therapy (provided in the home) Pediatric Behavioral Therapy Pediatric Personal Care Personal Care Private Duty Nursing Speech Therapy (provided in the home) Youth Day

Yes. Home health agencies, providing the above listed care services come under EVV mandate. If the agencies submit a claim for reimbursement without corresponding through EVV post January 1, 2021, they may face denial for the same.

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 toll-free number, accessible 24 hours a day, 7 days a week.
  • Cloud-based solution for home care agencies facilitates the same purpose through:

  • 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 Department audit.
  • Data Aggregator: The Data Aggregator is a solution provider to interface with both 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.

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 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:

  • 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 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. There is no mandate for that. States have significant discretion to choose 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 requires an in-home visit by a care provider. 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

Verification is required by member/representative at the end of every visit/shift

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

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

  • 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

States that have not implemented EVV by January 1, 2021 (for states with EVV extension under Good Faith Effort Exemption) will be subject to FMAP reductions. The states that made a “good faith effort” to comply and have encountered “unavoidable system delays” could receive an extension in implementing EVV.

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 that care providers must comply 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, 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.

Yes you can use an EVV solution as per your choice from a third-party provider. However, you may require to go through the pre-defined channel of the state or aggregator to implement EVV.

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

EVV allows verification of employee locations, hours of work for payroll and billing, visits being reported are actually taking place, and that the patients are getting the care they require. Better care delivery, gapless communications, enhanced productivity of the staff, and automation of key processes are some other benefits of implementing EVV. It also helps to curb fraud and ensure transparency in care quality with continuous tracking and monitoring.

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 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, 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.

The objective an electronic visit verification system is to reduce the need for managing paper timesheets manually. This will also help to eliminate the need for caregivers to report to the agencies with paper timesheets.

Yes, your agency will be the billing provider. The caregiver will not be billing Nevada Medicaid directly. All claims will still be mandated to be billed from the agency.

First, a home care agency or care provider should learn about the EVV requirements. They need to assess whether they want to go with State EVV Solution or a third-party EVV solution. Prior to the implementation, they also need to complete mandatory training.

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

No, client does not require to have a landline or cell phone. The verification of service through EVV is the responsibility of the home care agency. To punch in the visits and provide required care, a caregiver should be given the technology necessary for EVV. A client may allow a caregiver to use their personal landline or cell phone for EVV, but it is not a rule.

Yes. The implementation of EVV does not change the format or location of service delivery. Patients will continue to receive services in accordance with their service plan and 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 and can upload information when service is restored or connected to Wi-Fi. Alternatively there is a TVV option available in rural areas to use when a cell phone or landline is available. In situations where MVV and TVV are both unavailable, a provider may complete EVV requirements through the provider portal. Please note that manual entries are subject to increased scrutiny by the Department.

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

For MVV and TVV within the State EVV Solution, clocking-in and clocking-out would need less than a minute of a caregiver.

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).

Reporting the visit is the responsibility of the caregiver. Once the phone regains power, the visit can be saved. In case the visit is unable to be accurately recorded, the agency administrator may fix visit data within the provider portal. Please note, manually entered visits are subject to Department audit.

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 in use. 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 of their choice. A provider choice EVV system must meet Cures Act requirements and successfully 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 responsibility of the provider. There will be no fee to providers for connecting or transmitting data to the State EVV Solution.

If a provider choice system is unable to interface with the Data Aggregator, no EVV information will be transmitted. Thus, providers will be unable to 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 choose to utilize the State EVV Solution at any time. Since training and systems requirements for the State EVV Solution may differ from that of provider choice systems, the Department recommends that providers plan timelines accordingly to ensure a seamless transition.

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

Yes, the EVV training is mandatory for State EVV Solution users and provider choice EVV users. Human errors, along with 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 matching and scheduling of caregivers as per the client needs.

At the time of EVV implementation stage, the agency will be provided detailed instruction on how to set up each caregiver in the EVV system and providing them unique IDs that are used for visit verification. The EVV system will know and use each caregivers unique ID and information to automatically 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 start or end time.

Whenever there is a change in care plan, the EVV system will send the alert with a pop up message to the caregiver.

To deliver required care by the appropriate caregiver. Service provided only by an authorized and licensed caregiver.

Ideally, in such a situation it is recommended that the caregiver should capture start time and end time as they transition between care activities.

The EVV system is secured by a unique user ID and password. Agency administrators are responsible to generate unique login credentials for all the caregivers. It is the provider’s job to maintain the confidentiality of that information.

The technology used in 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 are built on technologies with offline functioning capabilities. As soon as 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 21st Century CURES Act, a caregiving agency need to implement EVV for claiming Medicaid. Every agency needs to implement EVV before January 1st, 2021.

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

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.

No, the agency needs to choose any EVV-based homecare management system that can maintain digital records that can be utilized for Medicaid.

The homecare management software with EVV 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.

As a caregiver agency, you need to consider relying on a home care management software with EVV, and it must be HIPAA-compliant.

Caregivers can get maximum benefits from an 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, you need to choose any third-party EVV software that is compliant with the state’s regulations once. However, there could be annual software maintenance charges, which also vary according to the policies of the service provider.

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

1st January, 2021 was the last date to implement EVV.

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!

An EVV software helps in tracking clock-in and clock-out timings of a caregiver delivering services.

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

Yes, most of the home care management software provide adequate scheduling information that can be altered by the caregiver agency, and requests could be made by the caregiver for changing shifts.

Yes, a unique identity number would be provided to each caregiver that would help in tracking caregivers from different agencies.

Yes, client has an access to the information related to the caregiver’s schedule and their visits.

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 to the agency.

Yes, clients, caregivers, and agency staff are offered adequate training for EVV from the EVV vendor.

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

Yes it is absolutely necessary to use EVV in order to continue to provide care services and be reimbursed. The claims that you submit without using this system will be denied.

Adults with overall household income up to 138 percent of the poverty. Children with overall household income up to 206 percent of the poverty. Pregnant women with an overall household income of 200 percent of poverty.

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