EVV Mandate

EVV Mandate
Is Your State Prepared to Meet the Electronic Visit Verification (EVV) Mandate?

On December 13, 2016, President Obama signed into law the 21st Century Cures Act. Section 12006 of the Act directs states to require an Electronic Visit Verification (EVV) system for Medicaid-funded personal care services. States have until January 1, 2019 to put requirements in place or they risk losing FMAP funding.

Under the new mandate, the EVV system must verify the following:

  • Date of service
  • Location of service
  • Individual providing service
  • Type of service
  • Individual receiving service
  • Time the service begins and ends

To date, 14 states have met this requirement. Some states and Managed Care Organizations (MCOs) require all providers to use a specific EVV system. This is called a “closed model,” and it puts significant burden on the states, providers, and caregivers.

Based on the significant issues with closed system implementations, the Partnership for Medicaid Home-Based Care (PMHC) is not a proponent of a closed system. Instead, our alliance of providers, payers, EVV vendors, and associations asks states to implement an open model system in meeting the EVV mandate.

The open model is a hybrid approach in which the state sets the standards for EVV, and providers and MCOs may either use their existing EVV system or choose one that best meets their needs. The state utilizes a vendor agnostic aggregator system to take in data from all EVV systems and apply standard business rules to ensure visits are properly verified. The aggregator system also generates alerts as needed and provides comprehensive oversight of the entire program.

We are pleased to provide our expertise in the deployment of EVV, lessons learned from states with EVV requirements already in place, and key areas for states to consider as they evaluate this new requirement.

PMHC EVV Deployment Resources:

PMHC White Paper- Understanding the Electronic Visit Verification (EVV) National Mandate 

PMHC Summary: Is Your State Prepared to Meet the Electronic Visit Verification (EVV) Mandate?

State Map – EVV Mandates (updated 02/01/2020)

PMHC EVV Predicted Models (updated 02/01/2020)

CMS Good Faith Effort Exemption Requests: State Requests

EVV Process Flow

PMHC Comment Letter – Arizona EVV Implementation

PMHC Comment Letter – Nevada EVV Implementation