Electronic visit verification (EVV) is a technology-based system that efficiently verifies home healthcare visits. It collects information by capturing time, location and attendance of home care workers.
A federally mandated requirement, EVV reduces the likelihood of error while promoting program integrity through a practical and simple monitoring system. It is designed to promote quality services and positive outcomes for our customers.
Why Illinois is implementing EVV:
In 2016, Congress passed the 21st Century Cures Act, which requires states to implement the use of Electronic Visit Verification (EVV) in all Medicaid-funded personal care services and home health care.
The current requirement mandated a compliance date of January 1, 2020, for all personal care services, and January 1, 2023, for all home health services. However, HFS requested and received a one-year federal extension of the January 1, 2020, implementation date. The Department currently estimates implementation for all personal care services in 2021.
Illinois must have an EVV solution in place or risk having their Medicaid claims denied, based on a mandate included in the 21st Century Cures Act. The federal requirements describe certain data point that must be collected electronically, but each state creates their own EVV system. Illinois will determine how we will gather and report data used within EVV.
The purpose of implementing EVV is to support Illinois’ goal to improve Medicaid program integrity, safeguard against fraud and abuse, improve program oversight, and comply with new federal requirements.
What services are impacted under EVV:
· Personal Care Services (PCS): Individuals receiving personal support in the home through Illinois’ Home and Community Based Services waivers, including:
o Persons with Disabilities waiver
o Persons with Traumatic Brain Injury waiver
o Persons with HIV/AIDS waiver
o Persons who are Elderly Waiver
o Adults with Developmental Disabilities Waiver
o Children and Young Adults with Developmental Disabilities Support Waiver
o Children and Young Adults with Developmental Disabilities Residential Waiver
· Home Health Care Services (HHCS): Individuals receiving home health services through the Medicaid State Plan
What providers are impacted under EVV:
Providers subject to the first round of EVV include: personal assistants, personal support workers and homemakers.
What EVV must capture:
· Type of service performed
· Individual receiving the service
· Date of the service
· Location of service delivery
· Individual providing the service
· Time the service begins and ends
The status of Illinois’ EVV implementation efforts:
The 21st Century Cures Act includes a provision that allows states to delay implementation of EVV for up to one year if a state has encountered unavoidable delays and they can demonstrate they have made a good faith effort (GFE) to comply with EVV requirements. On September 27, 2019, HFS submitted a request for a one-year GFE extension from the Centers for Medicare and Medicaid Services (CMS). CMS granted approval for that one-year extension on November 21, 2019.
HFS will work with stakeholders, sister agencies, providers and clients to implement a practical and efficient EVV system. The Department is committed to working with Members, Providers, and vendors to meet training needs and implement a quality solution as quickly as possible. We will be conducting stakeholder meetings, sending notices and using other tools to explain the process and take input.
· January 1, 2020 - Original deadline for all personal care services to begin using EVV (modified)
· January, 2021 - Begin to receive added stakeholder input, secure vendor RFP, conduct provider trainings. The Department will inform providers of coming steps throughout 2021.
· June 2, 2021 - The Request for Proposal (RFP) for Illinois' Electronic Verification has been posted. Proposals may be submitted through BidBuy
· January 1, 2023 - Deadline for all home health services to begin using EVV
Additional information pertaining to EVV will be posted on this website in the near future