Tags Posts tagged with "Medicaid-funded personal care and home health care services"

Medicaid-funded personal care and home health care services

As a reminder, section 12006 of the 21st Century Cures Act requires all states to implement the use of EVV for Medicaid-funded personal care and home health care services. EVV must be implemented for personal care services by January 1, 2020, and for home health care services by January 1, 2023.

OLTL waiver services included in the initial implementation of EVV:

  • Personal Assistance Services (Agency and Participant-Directed Model)
  • Participant-Directed Community Supports
  • Respite (unlicensed settings only)

As part of the soft launch period, claims submitted to PROMISeTM for services subjected to EVV will be validated against EVV visits submitted through the Department of Human Services (DHS) Sandata system or DHS Aggregator. During claims processing in PROMISeTM, EVV validation against the DHS Aggregator will continue to be performed and EVV Error Service Codes (ESCs) will set without impacting claim payment. The ESCs for EVV will become active on December 13, 2019, for claims submissions with dates of service on or after November 1, 2019. Providers are expected to review when the EVV edit(s) set and actively make corrections either to the data stored in the DHS Aggregator or the claim itself to ensure errors do not repeat.

Please see this chart of EVV-specific ESCs for reference. If you have questions about EVV, please refer to the Frequently Asked Questions document on the DHS EVV website or contact the EVV Resource Account.