Department of Medical Assistance Services
EVV Information


Department of Medical Assistance Services
Division of Aging and Disabilities
Electronic Visit Verification (EVV) Initiative in Virginia

Overview:

The federal 21st Century CURES Act signed into law on December 13, 2016 requires states to implement Electronic Visit Verification (EVV). States must comply with this requirement for Medicaid in-home personal care by January 1, 2019 and for Home Health Services by January 1, 2023.

The 2017 Virginia Appropriations Act expanded the use of EVV to include consumer directed personal care and respite and companion services effective January 1, 2019.

Definitions:

Electronic Visit Verification (EVV) systems are technology-based systems that electronically record when attendants begin and end providing services to individuals who have Medicaid. Such systems may include features to verify the attendant's location and assure that the attendant is in the beneficiary's home. These systems require a device like a phone, computer, or similar device to track attendant's start and end times.

Companion Services means nonmedical care, supervision and socialization provided to an adult (age 18 and older). The provision of companion services does not entail hands-on care. It is provided in accordance with a therapeutic goal in the plan of care and is not purely diversional in nature.

Personal care services means a range of support services necessary to enable the waiver individual to remain at or return home rather than enter a nursing facility and that includes assistance with activities of daily living (ADLs), instrumental activities of daily living (IADLs), access to the community, self-administration of medication, or other medical needs, supervision, and the monitoring of health status and physical condition. Personal care services shall be provided by aides, within the scope of their licenses/certificates, as appropriate, under the agency-directed model or by personal care attendants under the CD model of service delivery.

Respite Care means services provided for unpaid caregivers of eligible individuals who are unable to care for themselves and are provided on an episodic or routine basis because of the absence of or need for relief of those unpaid persons who routinely provide the care.

EVV Benefits:

There are several benefits to adopting an EVV system:

  • Promote quality outcomes for individuals (Quality of Care)
    • Greater opportunity for enhanced care coordination and data sharing.
  • Reduce billing errors and improve payment accuracy (Program Integrity)
    • Electronically verifies that a caregiver is physically present for a visit.
  • Promote oversight of the services provided
    • Comply with federal and state requirements.
Links:
Virginia Requirements:

EVV in Virginia will require providers to report seven data elements. The required data elements include: 1) The type of service(s) performed; 2) The individual receiving the service(s); 3) The date of the service; 4) The location of the service delivery (can either be in an individual's home or community setting); 5) The individual providing the service; 6) The time the service begins and ends; and 7) A unique identifier for the visit.

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For Providers and Health Plans:

The implementation of EVV in Virginia is ongoing. The Department of Medical Assistance Services encourages health plans and fee-for-service providers to stay informed about the requirements and expectations for implementing EVV. There are several things that you can do now: 1) Educate yourself about the commercial EVV systems on the market; 2) Inform your company or the individual that bills for services that the seven data elements listed above will be required to be submitted with each billing claim; and 3) Begin to develop information to share with the member's caregiver about EVV based on your EVV system. Additional information will be provided as CMS releases additional guidance to states.

For the Beneficiary and Caregiver:

The individual receiving services and supports and the caregiver should be informed about EVV. Foremost, it is important to be aware that EVV provides a level of assurance the caregiver is onsite to provide the services identified in the plan of care. This is a useful tool to reduce fraud, waste and abuse which promotes the integrity of the service. Additionally, your provider may have specific requirements that may involve the member or caregiver.