The implementation of electronic visit verification, also known as EVV, is one of the services that we provide at ABCS (Advanced Billing & Consulting Services). Recently, the state of California announced that people who deliver support services to individuals with developmental disabilities need to use an approved EVV (Electronic Visit Verification) system to record their visits.
This has generated some questions from I-DD provider agencies. The state of California will release more information over time, but the transition to the use of EVV systems is part of a larger national trend due to new federal legislation.
Why is California Requiring EVV?
Federal legislation, through the 21st Century Cures Act, requires that every U.S. state implement an EVV system for their Medicaid funded programs. In both Ohio and California, the New York based company Sandata Technologies was selected to operate the EVV data aggregation system. The computerized system that collects the EVV data is often simply referred to as the aggregator. These aggregators will collect, organize and store all EVV data for both provider agencies and independent service providers.
Due to this federal requirement, I-DD provider agencies who do not document their visits with a state approved EVV system, are at risk of receiving reduced reimbursements. The state of Ohio has already notified waiver provider agencies of this requirement. The state of California will likely have to follow a similar model.
What is Electronic Visit Verification or EVV?
The technology was originally introduced to the field of healthcare back in the 1990s. EVV is basically a phone and computer-based system that verifies the time and place for the delivery of healthcare services. In the 21st century, EVV systems now rely on GPS data to verify location as well as start and end times for care services. A major objective for EVV technology is to optimize the delivery of services while reducing any potential fraud.
If individual U.S. states are not in compliance with these federal requirements, the non-compliant states will risk losing their federal funding for state Medicaid programs. Across the country, the EVV program has been implemented in stages or phases. The second stage, or Phases II, includes services for individuals with developmental disabilities.
What EVV Data is Required by the State of California:
As of the date of publication, here is a summary on what all state approved EVV systems in California need collect. The DHCS (Department of Health Care Services) is requiring Medicaid-funded I-DD agencies to implement Electronic Visit Verification when they provide support services. Again, the federal mandate to transition to an approved EVV system waiver provider agencies is a newer legislative requirement that previously did not exist in this specific healthcare specialty.
DHCS is requiring that all I-DD agencies use a state approved EVV solution that is able to record, at a minimum, the following six data points:
- Date of the service.
- Time the service begins and ends.
- Type of service performed.
- Individual receiving the service.
- Location of service delivery
- Individual providing the services.
Concerns Over the Use of EVV & Individual’s Rights:
Over the years, people have expressed concerns about EVV’s impacted on people’s privacy rights. There are concerns that the government is tracking, or spying on, people in the Medicaid community. This is a serious concern that should not be taken lightly.
Government officials have stated that a goal of the EVV requirement is to reduce the occurrence of Medicaid fraud. A pro-EVV position argues that EVV technology helps to guarantee that individuals with developmental disabilities will receive all of the service hours that they are eligible to receive from Medicaid.
If individuals are supposed to receive five hours of personal care daily, a good EVV system can, at a minimum; verify whether their assigned caregiver was with them for these five hours of service. In other words, did the individual actually receive their five hours of personal care?
However, an EVV system is not perfect. For example, it can capture when and where a direct care worker delivered services, but not the quality of the service.
Arguments around the implementation of EVV will continue for some time. Many states are having collaboration meetings that discuss this very topic. For example, Disability Rights California (DRC) has stated that EVV systems need to be “minimally burdensome on IHSS recipients” while at the same time “not violate the legal rights of Californians with disabilities.”
Going Beyond the Visit – How Can EVV Help Agencies?
There are some positive outcomes that provider agencies can gain from this new federal requirement. These new regulations will encourage agencies to update their administrative practices and optimize their delivery of personal care services. I-DD agencies need to move away from the use of paper and pencil documentation as well as other inefficient and outdated administrative tools.
It is possible to meet federal compliance rules, while simultaneously reducing overall operational cost. Better analytics and reporting are possible with well-maintained EVV systems. Good workforce management and compliance tools allow agencies to track their servicecoverage while providing accountability metrics.
For example, the EVV system developed by ABCS is called eWebschedule. This EVV solution is specifically designed to meet the unique needs of agencies that provide personal care services for individuals with developmental disabilities. Some of the data that is capture includes:
- Documentation of shifts worked by direct support professionals (DSPs). The eWebschedule application automatically tracks which DSP shifts must be reported to the Sandata aggregator.
- Direct care staff are able to see the shifts a supervisor has authorized them to work. This view access includes any shift notes added by the supervisor.
- Uses mobile phone app technology. This includes required time collection by capturing scheduled and unscheduled visits, community/group visits as well as non-billable time.
- Instant communication to all staff members. This feature also includes a “Read Acknowledgement” option.
The EVV requirement is likely not going to disappear. However, the full implementation of the regulation has been delayed. In the long-run, agencies should get in front of the approaching change and prepare their staff for the future of their industry. With this in mind, the EVV system requirement does not have to become a burden. Instead, it is an opportunity to grow and create a more modern healthcare community.
Advanced Billing & Consulting Services has a long history of providing experienced and professional EVV compliant services and more.
Our eWebSchedule software delivers an effective and affordable EVV solution for Medicaid-funded personal care service providers. The EVV solution is cloud-based, secure and uniquely designed for the needs of California and Ohio personal care service (PCS) provider agencies.
As a software solution, eWebSchedule helps personal care service providers maximize their time. Beyond recording EVV data, they can also verify work schedules, check consumer information, communicate with their agency and more.
As a state approved EVV solution with integrated scheduling and billing, agencies improve their efficiency while limiting having to manually enter visit information. This reduction in data entry tasks helps agencies optimize their delivery of personal care services and save money in the long run.
To schedule a free demo, email or call them at 614-890-9822.
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