Q: Can you explain what Electronic Visit Verification is?

Electronic Visit Verification (EVV) refers to Sec. 12006 of the 21st Century CURES Act. This 2016 Federal Act requires an EVV system for all personal care services, and home healthcare services reimbursed by Medicaid. States were originally required to have EVV for all personal care services paid by Medicaid by January 1, 2019, but the date was delayed until January 1, 2020. Home care agencies that provide skilled-care services paid by Medicaid must have EVV implemented by January 1, 2023 (Medicaid.gov, 2018). States that fail to have EVV in place by January 1, 2020, and home care agencies that fail to have EVV in place by January 1, 2023, face reductions in reimbursement of matching federal funds (U.S. Health and Human Services, 2015). The purpose of EVV is to prevent abuse and fraudulent use of Medicaid funds.

EVV uses a global positioning system (GPS) location in the client's home. The three most common methods of submitting the data include: a GPS device in the client's home, an application on a smart phone, or the client's land line (telephony). Information submitted for the EVV process includes but is not limited to: individual receiving the service, job title of the person providing the service, service provided, date/time the visit begins/ends, and the location where the service is delivered to the client.

Home care agencies must be positioned to implement EVV in 2023. This provides the opportunity to advocate and shape public policy. Home care clinicians and agencies should be a part of selecting the right process for implementation. Advocating and engaging during stakeholder meetings can help ensure your agency's EVV system model is an opportunity and not an obstacle to your patient-centered care. State Medicaid plans will be holding EVV stakeholder meetings. Being at the stakeholder meetings is vital. Many states such as Connecticut, Florida, Ohio, Oklahoma, and Tennessee were early implementer states. These states provide valuable lessons learned to our industry.

Software companies have, or are in the process of, becoming EVV vendors or accommodating the new EVV requirement and working with EVV vendors. Currently, the preferred EVV models are open (any vendor type), provider choice (agency-selected software), and hybrid (either model). The least preferred are state choice and closed model based on information from states that have begun the implementation process. As states announce plans for EVV, be aware of the preferred models that decrease burden for the patient, the staff, and the agency. Everyone has an opportunity to advocate for a thoughtful well-planned EVV program that protects the resources entrusted to us to care for our patients. The models chosen by your state can be viewed on the Partnership for Medicaid Home Based Care (2018) webpage.

It should come as no surprise that a registered nurse from Ohio with experience in home care designed and patented the first EVV tool in 1996 to help prevent fraud and abuse, and to ensure that patients received the care they were promised (Wikipedia, 2018). As healthcare providers, we uphold the code of ethics of our professions that reflects our care and contribution to our patients and communities.

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