The EVV Bill proposed to reduce FWA while improving patient care

The Office of the Inspector General of Health & Human Services has identified that personal care services provided in Medicaid are at high risk for fraud, waste and abuse.  By using an electronic visit verification (EVV) solution, State Medicaid Agencies, Managed Care Organizations (MCOs) and homecare providers can reduce the level of fraud and improper payments, while ensuring that some of the most vulnerable Medicaid beneficiaries receive the care they need. 

Per the new bill (HR 2446 – The EVV Bill),  the EVV system must verify the following:

  • date of service

  • location of service

  • individual providing service

  • type of service

  • individual receiving service

  • time the service begins and ends

In order to prepare for such a mandate, payers and providers should consider an EVV system that provides real-time visibility and audit trails into visit confirmation and caregiver / duty compliance.

Systems with additional functionality such as auto-broadcasting referral and acceptance features is most ideal. A system should enable real-time communication between the State or MCOs and the network of homecare providers to enhance care coordination, ensure compliance and streamline the billing process.

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