Electronic Visit Verification (EVV)

What is EVV?
 
On December 13, 2016, the 21st Century Cares Act (Cures Act) was enacted into law.  The Cures Act is designed to improve the quality of care provided to individuals through further research, enhanced quality control and strengthened mental health parity.  An EVV system is a telephone and computer-based system that electronically verifies service visits occur and documents the precise time service begins and ends.  EVV applies to services rendered in the home under Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and home health skills.  Currently, federally required implementation dates vary depending on the type of service being provided:  Personal Care Services (PCS) deadline is January 1, 2020 and Home Health Care Services (HHCS) is January 1, 2023.

PCS are identified as a hands-on, direct-care services, such as those provided in any of the following programs: 
  • Aged and Disabled Waiver (ADW)
  • Traumatic Brain Injury (TBI) Waiver
  • Intellectual/Developmental Disabilities Waiver (IDDW)
  • State Plan Personal Care Programs
The West Virginia Department of Health and Human Resources (DHHR) has been working with the Centers for Medicare and Medicaid Services (CMS) to establish finalized implementation dates. On July 30, 2018, legislation passed to amend Section 1903(l) of the Social Security Act to delay the EVV timeline for PCS until January 1, 2020, or otherwise be subject to Federal Medical Assistance Percentages (FMAP) reductions as follows:
  • 0.25 percentage points for calendar quarters in 2020
  • 0.5 percentage points for the calendar quarters in 2021
  • 0.75 percentage points for the calendar quarters in 2022
  • One percentage point for calendar quarters in 2023 and each year thereafter

It is important to note that this legislation does not affect timelines for home health care services.

 

 
How is West Virginia Implementing the EVV Solution?
 
 
The State of West Virginia has chosen the Open/Hybrid Model for the EVV Solution.
  • The State Procured Solution:
    • The burden and cost of procurement is the responsibility of the State.
    • the State is responsible for maintenance and updates to the system.
    • the upgrade options may be available for providers to implement, at cost to them.
  • The Provider Owned Solution:
    • The burden and cost procurement is the responsibility of the provider.
    • The providers are responsible for providing evidence that their system complies with the requirements of the Act, DHHR, and the data aggregator, as well as any associated costs.

The Open/Hybrid Model has benefits and challenges like any other model.

Open/Hybrid Model Benefits

  • The State can secure enhanced match for IT development and installment of state-run system.
  • The providers have a centralized platform to use without running their own procurements, alleviating burden, if they choose.
  • The providers have the option to select their own EVV system if they would prefer.
  • The centralized platform facilities linking EVV with the Medicaid Management Information System (MMIS) claims data.

State benefits include:

  • The least disruptive environment, most complexity for the State.
  • The approach qualifies for CMS enhanced match 90% and 75%.

Provider benefits include:

  • The maximum flexibility - use free system or system of their choice.
  • The Open/Hybrid Model is best suited for small and large providers.
  • The Open/Hybrid Model will require integration with the State aggregator solution.

Quality Monitoring:

  • You can expect a high level of compliance.
  • there is real-time visit data available to the payers and providers.
  • the alerts can be configured for quality assurance.

Open/Hybrid Model Challenges

  • The State procurement processes can be lengthy and arduous.
  • The providers must have the capacity/IT to access the State system.
  • The need to ensure that all systems are interoperable, which could create challenges if the system is modified or upgraded.

The State of West Virginia is currently taking the following steps to further implementation of EVV:

  • Working with CMS, internal and external partners to obtain federal and state funding.
  • Finalizing acquisition strategies and will solicit bids from vendors.
  • Selecting a vendor and a system.

  

Contact Information
If you have any questions, comments, or suggestions regarding EVV, please contact BMS at: DHHRBMSEVV@wv.gov.
Additional Information

The development and implementation of the West Virginia EVV System is supported in part with rebalancing funds of the Take Me Home, West Virginia.  Take Me Home, West Virginia is a Money Follows the Person Rebalancing Demonstration Grant (DHHR Grant Number 1LICMS330830) from the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services.
 
 
 
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