What Every Virginia Provider Should Know About EVV
As a Virginia homecare provider, you’ve probably already begun the process of implementing Electronic Visit Verification (EVV). But if you’re unsure about everything you need to do to be compliant with the federal mandate, don’t fear – we’ll walk you through everything you need to know in this blog post.
About EVV and the Cures Act
EVV has been around for more than twenty years, and with the passing of the 21st Century Cures Act, EVV is now a requirement for Medicaid homecare providers. The Cures Act requires homecare visits to be electronically verified for the type, date, and location of the service being performed; the individual receiving the service; the caregiver or aide performing the service, and the time the service begins and ends.
HHAeXchange is the industry leader in providing EVV solutions across the country with over 214 million visits confirmed annually through our platform, and we are actively providing solutions to meet EVV requirements for Virginia homecare agencies. Check out all of the details below to get up to speed on what’s happening in VA.
When is Virginia’s EVV deadline?
EVV for personal care, respite care, and companion services in Virginia went into effect on October 1, 2019. However, Virginia’s Department of Medical Assistance (DMAS) was granted a Good Faith Effort (GFE) Exemption from the Centers for Medicare & Medicaid Services (CMS), which delayed EVV compliance to September 1, 2020.
Was there a transition period for complying with the EVV mandate?
Yes, there was an extended transition period from October 1, 2019 to August 31, 2020 to allow providers additional time to comply with the EVV requirements. During this transition period, agency directed providers and consumer directed attendants were reimbursed for services regardless of whether EVV information was present. For claims submitted on or after September 1, 2020, however, EVV is required and reimbursement will be denied for services not compliant with EVV requirements.
Whom does this impact?
EVV is required for all home health services including home health visits, private duty nursing, and personal care services. According to DMAS, providers must:
Verify delivery of services using an EVV system at the beginning and end of each home health service visit.
Submit claims through the vendor’s system to verify that delivered services comply with prior authorizations before claims can be processed for payment.
What is the status of EVV in Virginia?
Virginia is an Open Model state and has decided to implement EVV with a provider choice approach. This means providers are free to choose any EVV solution that best meets the needs of their agency. The only requirement is that the selected EVV solution collects all six data elements as specified in the Cures Act and maintains those records for at least six years.
What if I’m connected with an MCO?
If you’re contracted with one of the MCOs (Aetna Better Health, Anthem HealthKeepers Plus, Magellan Complete Care, Optima Family Care, UnitedHealthCare Community Plan, or Virginia Premier), you can continue to use your current EVV solution, as long as your vendor can send the correct information to the MCO’s visit confirmation and claims platform. Virginia’s MCOs will be responsible for collecting providers’ EVV data and submitting it to the state. If an agency is involved with the Consumer Directed program, the Fiscal/Employer Agent will provide an EVV system.
What are the penalties?
If a provider fails to comply with these rules, they are subject to denial or non-payment of claims, sanctions, fines and suspension, or termination from the Virginia Medicaid program.
What are my next steps?
Since Virginia is an Open Model state, providers are free to choose the EVV solution that best meets the needs of their agency and complies with the Cures Act requirements. If you currently use HHAeXchange for EVV, you are in compliance with Virginia’s mandate. If you still need to find an EVV solution before the deadline, contact us to learn more.