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Electronic Visit Verification


Overview

For the most recent information on Electronic Visit Verification (EVV), please review the updated Frequently Asked Questions document. Virginia Medicaid thanks our providers for complying with the EVV requirements implemented by the Centers for Medicare and Medicaid Services on September 1, 2020.

We want to hear from our providers now that these rules are in place. What is working? What areas need improvement going forward? To share your feedback or ask additional questions about EVV, please email EVV@dmas.virginia.gov.


The federal 21st Century CURES Act of 2016 requires states to implement EVV. Subsequent legislation extended the deadline for states to comply with the EVV requirement for Medicaid personal care services to January 1, 2020. There was no change in the date for home health services: January 1, 2023.

The Virginia Appropriations Act expanded the use of EVV to include consumer-directed personal care and respite and companion services.

EVV requirements remain in effect for agency and consumer directed personal care, respite, and companion services. To ensure prompt and proper payment for services provided to members during the emergency declaration, DMAS continued paying claims regardless of the status of EVV data on the provider's claims until August 31, 2020. This applies to services provided through fee for service, Commonwealth Coordinated Care Plus (CCC Plus) and Medallion 4.0 managed care plans.


Benefits

There are several benefits to adopting an EVV system:

  • Promote quality outcomes for individuals (Quality of Care)
    • Greater opportunity for enhanced care coordination and data sharing.
  • Reduce billing errors and improve payment accuracy (Program Integrity)
    • Electronically verifies that a caregiver is physically present for a visit.
  • Promote oversight of the services provided
    • Comply with federal and state requirements.

 



Virginia Health Plans

Electronic Visit Verification Documents from Virginia Health Plans

Aetna

Anthem

Magellan

OptimaHealth

United Healthcare





Beneficiary & Caregiver

The individual receiving services and supports and the caregiver should be informed about EVV. Foremost, EVV provides a level of assurance the caregiver is onsite to provide the services identified in the plan of care. This is a useful tool to reduce fraud, waste and abuse which promotes the integrity of the service. Additionally, your provider may have specific requirements that may involve the member or caregiver.

Vendors

Vendors are encouraged to review the two links about the Companion Guides above along with the FAQs and the Draft EVV Regulations.

Contact

For additional questions about Electronic Visit Verification (EVV)

One Page Overview

Electronic Visit Verification (EVV) is a requirement under both state and federal law for certain services paid through the Medicaid program.


Regulations

The EVV Regulations were published in the Virginia Register of Regulations on January 20, 2020. The comment period ran through March 21, 2020. DMAS staff are reviewing all comments.