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​Electronic Visit Verification (EVV)

The 21st Century CURES Act requires Electronic Visit Verification (EVV) systems for Medicaid-funded personal care services (PCS) and home health care services. To learn more, check out the EVV overview presentation.

EVV Implementation Updates

Frequently Asked Questions

Have questions about EVV?

Have ODP-specific questions?

Background/General Information

Section 12006 of the 21st Century CURES Act requires states to implement an EVV system for Medicaid-funded Personal Care Services (PCS) by January 1, 2019, and for Home Health Care Services (HHCS) by January 1, 2023. Federal legislation delayed penalties for PCS implementation until January 1, 2020. Additional information about the 21st Century CURES Act can be found on the Centers for Medicare and Medicaid Services (CMS) website.

EVV Explained

What Information Must the EVV System Collect?

The CURES Act requires that EVV systems must collect and verify the following:

1. The type of service provided.
2. The name of the individual receiving service.
3. The date of service delivery.
4. The location of service delivery.
5. The name of the individual providing the service.
6. The time the service begins and ends. 

What is considered PCS?

The CMS states that PCS consists of services supporting activities of daily living (ADL) such as movement, bathing, toileting, transferring, and personal hygiene or offers support for instrumental activities of daily living (IADL) such as meal preparation, money management, shopping, and telephone use. For Pennsylvania this includes:

Office of Long-Term Living (OLTL) Waivers
CHC 1915(c) Waiver, OBRA Waiver, and Act 150 Program
(
Includes Agency and Participant-Directed Services)

    • Personal Assistance Services
    • Respite (unlicensed settings only)
    • Participant-Directed Community Supports

Office of Developmental Programs (ODP)
Consolidated, Person/Family Directed Support Waiver (P/FDS), Community Living Waiver, Adult Community Autism Program (ACAP), and Intellectual Disabilities/Autism (ID/A) Base Services (Includes Agency and Participant-Directed Services)

    • Companion
    • In-Home and Community Support
    • Respite (unlicensed settings only)
    • Homemaker

    Adult Autism Waiver

    • Community Support
    • Respite (unlicensed settings only)
    Adult Community Autism Program (ACAP)

    • Specialized skill development
    • Respite (unlicensed settings only)
    • Homemaker
    • Personal assistance
Office of Medical Assistance Programs (OMAP)

PCS are home health aide or certified nurse assistant services provided to individuals under 21 years of age by a home health agency.

What is a PA Doing to Implement an EVV System?

DHS is working with DXC and Sandata to develop an EVV system that will integrate with our existing Medicaid Management Information System (MMIS), PROMISe. DHS is developing the state EVV system with a soft launch by October 2019. DHS will be sending out regular updates on the progress of the implementation and will be reaching out to provider agencies with surveys, informational updates, and stakeholder briefings throughout the implementation process.

While DHS will offer the DHS EVV system to providers, Pennsylvania is using an open EVV system model. Providers may use their own EVV vendor/system as long as their system captures the six items required under the CURES Act and can interface with the DHS Aggregator (defined below). Technical specifications for alternative EVV systems to interface with the DHS Aggregator will be made available once they are finalized.


What Kind of System is Pennsylvania Using?

Pennsylvania will use an open EVV system. Under an open system:

    • Providers with an existing EVV system may continue to use their system as long as that system can send information to the state system. The state-run system will receive information from the non-state system.   
    • Providers without an existing EVV system can use the state-provided EVV system.

When Will Pennsylvania Implement EVV?

The plan for Pennsylvania’s implementation of EVV is:

    • Jan. 1, 2020 — All providers began using EVV for PCS.
        • Error Service Codes (ESC) are in effect for claims submitted through PROMISe for services subjected to EVV.
        • Providers should review the ESCs to identifty whether claims are supported by EVV visits in the DHS Aggregator. These ESCs will assist providers in understanding when claims would deny beginning Oct. 1, 2020.
    • June 1, 2020 — All providers must complete the EVV compliance audit survey which can be found here: www.surveymonkey.com/r/WVBZHZN

    • July 1, 2020All providers using Alternative EVV must begin the certification process no later than this date.

    • Providers using Alternate EVV who have not already reached out to begin this process must contact Sandata Alternate EVV support team by phone at 1-855-705-2407 or by email at PAAltEVV@sandata.com.  This process began in August 2019, so if your agency is currently in the certification process, or previously completed certification, no action needs to be taken.

    • The Alternate EVV process takes approximately 4-6 weeks for completion. The Quick Reference Guide from Sandata outlines the Alternate EVV process and the required actions for Providers, Alternate EVV vendors, and Sandata throughout the eight-step process.

    • Starting October 1, 2020: PCS claims submitted without a matching EVV visit will be denied.

 

What EVV Vendor can Providers Use for Community HealthChoices (CHC)?

Providers serving participants who are already enrolled in one of the CHC Managed Care Organizations (MCOs) will have the option to use the MCO’s EVV system, HHAeXchange. A CHC-participating provider with its own internal EVV system must work with each contracted MCO to ensure the provider’s system is able to send information to HHAeXchange. Providers should begin discussing training and system options with their contracted MCO(s) in order to implement EVV by September 2019.

For participant-directed programs in the Office of Long-Term Living (OLTL) waivers, the vendor fiscal agent — Public Partnerships, LLC (PPL) — will be utilizing their EVV system, Time4Care, to satisfy EVV requirements.

 

DHS Sandata EVV Training

PA DHS, DXC, and Sandata are using a “train the trainer” approach. One person from each agency must attend training in order to use and access the DHS Sandata system. Those users can train other agency staff using recorded webinars or the online library of role-based training modules as aids. A maximum of two individuals per agency may complete the classroom and webinar training sessions. At least one of the agency employees who participate in training should be an EVV system administrator. At least one representative of your agency must complete all required training to receive your login credentials to the DHS Sandata system. You will need credentials to input your direct care workers’ data into the system. If your agency operates with multiple provider numbers, you must satisfy the training requirements for each provider number (9-digit MPI).


 

Available training

  • DHS Sandata Training Materials  
  • Independent Web-Based Training
    This online, self-paced training method allows participants to access online, role-specific training materials independently. The materials will be available beginning September 24, 2019, and will be available 24-hours a day, seven days a week for the life of the program. Independent web-based training can be a great resource as a training refresher or a way to train new providers.
    • Duration: Self-paced.
    • Participation: There is no limit on the number of agency employees that can participate in web-based training.
    • Registration Link

The first person to complete training from your agency will receive the Welcome Kit with security credentials to DHS Sandata EVV. The Welcome Kit will be sent via email to the appropriate business email that is linked to the registered account. Once received, the administrator will have the security credentials to provide log-in access to the EVV users in your agency.

 

If you have any questions about training registration, please call the Pennsylvania EVV Support Hotline at 1-800-248-2152. Any additional questions can be sent via email to ra-pwevvnotice@pa.gov.