In 2016, the 21st Century Cures Act was signed into law. This act requires states to implement EVV (Electronic Visit Verification) for personal care services and home health care services provided or reimbursed by Medicaid. This is meant to enhance the quality and accuracy of care services through accountability and standardized record keeping. Here’s what services need to be electronically verified, what benefits EVV includes, and how agencies can choose their own EVV solutions.
What is EVV for Medicaid services?
EVV is the use of electronic means to verify care provider visits for home health and personal care services. It also collects information such as the:
- Type of service provided
- Individual receiving the service
- Date of service
- Location of service delivery
- Individual providing the service
- Time the service begins and ends
EVV was designed as a modern way to record the location, time, and tasks performed by care providers. These records ensure that there’s a running log of the services provided to the Medicaid patient that can be referred back to during future care planning or in case of questions about the efficacy of the provided care.
Which services need to be electronically verified?
According to the Centers for Medicare and Medicaid Services (CMS), “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 other words, any time that a healthcare service or personal care service is provided in a private home–and Medicaid or Medicare is paying for it–electronic verification is mandatory. This does not apply to nursing homes or hospitals.
EVV for Medicaid services in Arkansas
CMS approved the Arkansas EVV Good Faith Effort Exemption request in October of 2019. This means that Arkansas has until January 1, 2021 to implement its EVV programming. During this initial roll-out, EVV will be required for personal care, respite services, and attendant care.
EVV for Home Health will be implemented by January 1, 2023.
How will it affect my quality of care?
EVV aims to reduce fraudulently recorded home visits and to ensure that patients are receiving the care that they need and aren’t being neglected. EVV verifies that actual visits are being made for every home healthcare visit billed to Medicaid. The reduction of fraud will decrease the cost of Medicaid overall, which benefits the state, the federal government, and taxpayers across the country.
In fact, it’s used by many companies in the healthcare industry, not just by government entities. Because EVV verifies employee location as well as patient care received, it can be used for quality assurance, compliance tracking, and reporting. Many organizations also use it to verify time sheets for care providers and healthcare workers.
The benefits of EVV for Medicaid services
According to the Congressional Budget Office, EVV solutions will save the federal government $290 million in Medicaid fraud over the next decade. Aside from compliance, EVV offers many other benefits for care providers. These include:
- Integration with electronic health records (EHR)
- Communication with caregivers in the field
- Boosting caregiver productivity with real-time charting
- Converting paper-based workflows into electronic forms
- Automating timekeeping
- Tracking mileage for reimbursement and tax purposes
- Monitoring caregiver safety
- Providing turn-by-turn directions for caregivers
- Optimizing schedules and routes for greater efficiency
Deploying the systems and technology required to meet the EVV mandate can help care agencies improve their communications and enhance their administrative processes.
EVV provider enrollment requirements
In order for agencies to bill Medicaid for personal care, attendant care, and respite services, all caregivers who will be using EVV must enroll with Arkansas Medicaid. This is a mandatory regulation.
Caregivers can enroll through the Provider Portal online, or they may fill out a paper application to mail in. Once enrolled, you’ll receive a provider number (also called a PIN).
How does EVV for Medicaid services work?
EVV uses GPS tracking connected to computer software. Many third-party tracking systems offer access to a smartphone app, but they can also include the use of telephone-based systems, enabling healthcare workers to call in from each location.
Either way, EVV requires a “check-in” protocol that records when a client is receiving care. Most EVV software providers use cloud-based systems that integrate with a mobile app to record and coordinate billing, payroll, scheduling, patient communication, internal communication, and service documentation.
When EVV is being used to track employees’ locations and hours worked, they often integrate with payroll systems for verification purposes and to streamline the timesheet approval and payroll process.
Can agencies choose their own EVV solutions?
There are five EVV models from which the states were allowed to choose.
1. State-mandated in-house system
The EVV system will be developed and operated by the state.
2. State-mandated external vendor
States contract with one EVV vendor to create a state-wide solution.
3. Open vendor
States contract with at least one vendor or create and operate the in-house system. However, agencies are allowed to choose this or any other third-party solution that meets federal and state requirements.
4. Provider choice
States set EVV standards and data collection requirements, and agencies can choose their own EVV vendor so long as it meets those requirements. However, they must pay for the implementation.
5. MCO choice
Managed Care Organizations (MCOs) choose and reimburse an EVV vendor.
Arkansas’ EVV solution
Arkansas operates on the open vendor model, which means that agencies can choose their own third-party vendor, whether or not it’s the one use by the state. Most states chose a vendor option, because when a solution operated by the state or by a vendor that has been sponsored by the state is used, the organization qualifies for federal medical assistance percentage (FMAP) matching funds.
You can receive 90% matching funds for the implementation of your EVV system and 75% matching funds for your ongoing EVV costs.
For more information
If you have any questions about how EVV for Medicaid Services will affect your care or your job, contact Integrity, Inc. today at (501) 406-0442. We’re happy to walk you through the enrollment process and to make sure you’re in compliance.