On December 24, 2019, DHS announced the approval of the Department’s Good Faith Effort (GFE) Exemption application for the Electronic Visit Verification (EVV) implementation. This GFE does not change DHS’ expectations of providers of personal care services to comply with the requirements of the 21st Century Cures Act. The Department will continue with a soft launch period through June 30, 2020. Throughout this time, providers must begin using EVV and complete any integration and certification activities if they have not been completed already. The Department continues to develop a policy bulletin that will outline additional requirements, including compliance benchmarks for manually edited visits. This bulletin will be released as soon as it is finalized.
During claims processing in PROMISeTM, EVV validation against the EVV Aggregator will continue to be performed and EVV Error Service Codes (ESCs) will set without impacting claim payment. During the extended soft launch period, the expectation is that provider/provider agency/Agency with Choice and Vendor Fiscal/Employer Agent billing staff will note when the EVV edit(s) set and actively make corrections either to the data stored in the DHS EVV Aggregator or the claim itself to ensure errors do not repeat. DHS will be monitoring which EVV edits set and how often.
Regular updates to the stakeholder community will be made on the progress of the implementation. Outreach and technical assistance will be performed based on results and as applicable. As of July 1, 2020, any claims without a corresponding EVV visit or any mismatches between what is found on the claim versus what is found in the EVV Aggregator will be denied.
2020 EVV Implementation Timeline:
- January 1, 2020: All Providers must begin using EVV for Personal Care Services (PCS).
- January 2020 – March 2020: All Providers must complete system integration activities with the DHS Aggregator for fee-for-service programs. Providers who are experiencing difficulties in integrating and will not be ready by March 2020 are asked to submit an extension request using this form, documenting the difficulties they are experiencing no later than February 1, 2020. The completed form should be emailed to the EVV resource account.
- Starting July 1, 2020: Claims submitted for Personal Care Services without a matching EVV visit will be denied.
If providers have not yet completed the necessary steps to implement EVV, please contact the appropriate entity to complete the necessary training and system integration activities.
OLTL and ODP Fee-For-Service Providers
- The DHS Sandata system training is available for providers electing to use the DHS Sandata system. Providers using the DHS system must complete this training in order to begin setting up their agency accounts and security permissions. Providers may register for the independent web-based training offered through Sandata here.
- The DHS Aggregator will receive information from Alternate EVV systems being used by providers in fee-for-service programs.
- Providers using Alternate EVV systems should contact Sandata at 855-705-2407 to complete Alternate EVV system integration activities for fee-for-service programs.
Current Community HealthChoices (CHC) Providers and Aging, Attendant Care, and Independence Waiver Providers
- If providers are electing to use the HHAeXchange EVV system offered by the Managed Care Organizations (MCOs), providers must work with the MCOs to complete training and other onboarding requirements.
- Providers using Alternate EVV systems in CHC will need to send their EVV data to the CHC-MCOs.
- Providers should contact HHAeXchange to complete Alternate EVV system integration activities for CHC.