Specifications include, but are not limited to: Medicaid Personal Care and Home Health Care providers to help mitigate the cost for providers to become compliant with the 21st Century Cures Act Electronic Visit Verification (EVV) requirements. The 21st Century Cures Act (CCA) under Section 12006 (a) mandates that states implement Electronic Visit Verification (EVV) for all Medicaid Personal Care Services (PCS) and Home Health Care Services (HHCS) that require an in-home visit by a provider. This applies to PCS provided under sections 1905 (a) (24), 1915 (c), 1915 (i), 1915 (j), 1915 (k), and Section 1115; and HHCS provided under 1905 (a) (7) of the Social Security Act or a waiver. The State has contracted with First Data Government Solutions (“Fiserv”), to provide the State’s EVV system including a data aggregator, which will connect with any provider’s existing EVV system with some modification. The State’s EVV implementation timeline is currently estimated to pilot with a small number of providers in late November 2023, and implement statewide for both Personal Care and Home Health Care services on January 1, 2024. The Department plans to collect the six required data elements, as well as the tasks performed by the direct service provider during the visit. Providers will have the choice to enter data directly into the State’s EVV solution, or external EVV visit data, collected by the provider’s EVV solution and sent to the State’s aggregator. Claims will be produced based on EVV visit data and will be sent via interface file to our Medicaid Managed Care Organizations (MCO), or to the Medicaid Management Information System (MMIS) for claims adjudication. A mobile application on a smart device will be the primary method of capturing EVV visit data with landline interactive voice response data capture serving as a backup. GPS within the device will be used as the method for validating location of services. Location shall be validated only at the beginning and at the end of the visit. If GPS location functionality is not possible, location may be validated via a landline. The Department plans to do a soft implementation with all providers. This phase will last about three to six months, during which time providers will have flexibilities to support a transition to the new process. These flexibilities may include, for example, allowing a higher number of manual entries per provider.
