Electronic Visit Verification (EVV) today.
As the EVV landscape and requirements continue to develop, it’s more than likely that your organization is still weighing and identifying which, if any, of your services are required to comply with EVV. Here is a brief refresher on what EVV looks like.
- In an effort to combat fraud, Electronic Visit Verification was federally mandated in the 21st Century Cures Act in 2016.
- EVV was designed to help verify that services billed for home healthcare are for actual visits made.
- EVV mandates the collection and submission of 6 key points of data to a Medicaid-designated state agency, plus an audit trail, that will help prevent fraud by verifying in-home visits match the authorization. More details.
Each state is implementing EVV as they see fit. Some states require additional services in additional settings (like telemedicine) to meet EVV requirements; others are seeking minimal compliance. Some states require many services/service codes to adhere to EVV; some only selected a handful of personal care service codes. Some have chosen not to comply with the federally-mandated deadline of January 1, 2021; some have complied earlier.
EVV for Applied Behavior Analysis.
- Only 2 states (Colorado and South Florida regions 9,10,and 11) currently require ABA to comply with EVV requirements. CentralReach is preparing for the compliance deadlines for South Florida on December 1st, 2020 and Colorado on January 1st, 2021 for ABA services only. After these dates, Medicaid claims may be denied if EVV compliance is not met by providers.
- Additional states, such as Arizona and California, are likely to require ABA to comply with EVV at an unspecified point in time. This could be months or years in the future. CentralReach is closely tracking this and is committed to serving our ABA providers in these and all states.
- Today, about 32 states are open (meaning CentralReach could provide EVV integration to them), though some states are still undecided between an open or closed model.
How to comply with my state requirements.
CentralReach tracks EVV by regularly checking state Medicaid information portals and reaching out to each state Medicaid office. However, providers are often the first to know of new mandates, as Medicaid is not obligated to answer or update CentralReach as a third-party vendor.
We recommend that providers do the following in order to ensure they are aware of new information and changes made to their state’s EVV mandates:
- Subscribe to Medicaid notifications
- Reach out to your state office for information and/or recommendations required
- Attend stakeholder meetings to help ensure your state EVV regulations appropriately handle the nuances of the ABA field
ABA providers in Colorado and South Florida have upcoming deadlines and must choose a solution to be EVV-compliant or risk Medicaid claim denials. Providers in those states have the following options:
- South Florida: ABA providers in regions 9,10 and 11 can use the state-provided solution, Tellus, or sign up for CR Mobile and CentralReach’s integration to Tellus.
- Colorado: ABA providers can use the state-provided solution, Sandata, or sign up for CR Mobile and CentralReach’s integration to Sandata.
CentralReach’s EVV-compliant solution saves time and prevents error by integrating EVV data collection, clinical ABA data collection, scheduling, billing, and more on our all-in-one system. The new CR Mobile app collects EVV information, and the CentralReach platform submits the EVV information to the aggregator designated by each state Medicaid office. By using CR’s always-improving application in tandem with CentralReach’s best-in-class practice management system, more and more providers will be able to achieve compliance and quality service delivery via one single system.
CentralReach’s EVV commitment.
As Medicaid is often the first payor to establish new requirements, with other payors following suit, we are committed to continuing to provide EVV integration for additional states and services.
Disclaimer: EVV information changes rapidly. This blog is for informational purposes only and does not constitute legal or clinical advice. You should always consult an attorney for legal decisions, and confirm applicable payor and clinical guidelines.