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CMS Issues New FAQ on Electronic Visit Verification

The Centers for Medicare and Medicaid Services (CMS) has released new guidance, including a new Frequently Asked Questions document, on the mandate that states require electronic visit verification (EVV) for personal care services by January 1, 2020 and for home health care services by January 1, 2023.  The guidance is at https://www.medicaid.gov/federal-policy-guidance/downloads/cib080819-2.pdf.

The FAQ addresses EVV applicability regarding beneficiaries with live-in caregivers, services delivered partially in the beneficiary’s home, and the provision of medical supplies, equipment, and appliances as a component of the Medicaid home health benefit.  It clarifies that web-based electronic timesheets with dual verification are not a permissible form of EVV as they do not provide the state with auditable confirmation of the data entered by the provider and approved by the individual. 

The FAQ also clarifies that EVV is only required for the portion of the service rendered in the home; however, states may choose to require more information to control fraud, waste, and abuse. It offers various methods of verification as options for alleviating privacy concerns regarding tracking of community locations while ensuring that the location of any portion of a service delivered in the home is recorded. States may select the approach that best aligns with their systems and program integrity goals.

The Department of Health intends to make a request to CMS that EVV implementation for personal care services be delayed for one year, from January 1, 2020 to January 1, 2021. The EVV statute allows states to seek up to one year of additional implementation time if they can demonstrate they have made a good-faith effort to comply and have encountered unavoidable delays.

To obtain more information on the EVV requirement, click here. For questions or concerns, email EVV@cms.hhs.gov.  LeadingAge New York will keep members updated as New York proceeds with its own implementation plan for EVV.

Contact:  Meg Everett, meverett@leadingageny.org, 518 867-8871.