Electronic Visit Verification (EVV) guarantees patients are receiving home health care services in accordance with Medicaid guidelines. But did you know that EVV requirements can vary by state?
Although individual states can determine how its EVV system will be set up, federal law specifies what data must be collected. Not only are states free to create EVV systems as they see fit, but states can use different methods and procedures to gather and report data.
Home healthcare organizations need to understand both federal and state-specific EVV guidelines to ensure compliance. In this guide, we will cover EVV requirements by state and how time and mileage tracking software like Timeero can simplify compliance for your business.
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Electronic Visit Verification (EVV) is a method that uses technology to confirm the details of home healthcare visits. The essential details EVV gathers about a home visit includes:
The location where the care was provided (ex: patient’s home)
The healthcare worker delivering the care
The medical or care service delivered
The patient who received care
The exact date that care was provided
The start and end times of the service
In 2016, the 21st Century Cures Act was signed into law, requiring states to set up EVV systems to document details of home health visits. Without EVV, patients that are eligible for Medicaid personal care services (PCS) and home health care services (HHCS) that require in-home visits risk claims being denied.
Additionally, Electronic Visit Verification minimizes the occurrence of fraudulently documented home visits. For example, caregivers may exaggerate the amount of time they spent rendering care to individual patients in the hopes of receiving unearned compensation.
One of the most important goals of EVV is to see that no patient is left without care or neglected. If a caregiver provides substandard care, EVV documentation allows managers and directors to intervene and address unwanted practices, ensuring patients receive the best possible care.
Types of EVV models
Currently, there are 5 different EVV models that states may choose to use.
1. State selected EVV
In this model, the state chooses a single vendor that every healthcare organization is expected to use. The vendor provides a one EVV solution for all agencies to use, easing access to patient records and standardizing data.
Pros
Standardization: Data remains consistent throughout all agencies, making sharing insights and metrics easier.
Reduced start-up costs: Potentially lower start-up costs due to volume discounts negotiated with the single vendor.
Simplified implementation: A single EVV system reduces the complexity of integrating multiple EVV solutions.
Cons
Limited choice: Providers may have less flexibility in selecting a system that best suits their specific needs.
Potential for vendor monopoly: The single vendor may have significant market power.
2. Provider choice/ Open vendor EVV
Under this model, healthcare organizations are free to use the electronic verification vendor of their choice. However, the downside to using this model is that the organizations bear the costs of implementing the solution. In some states, reimbursement is provided to help agencies offset these costs.
Pros
Flexibility: Providers can select a system based on how well it fits their preferences and workflow.
Innovation: Having multiple EVV systems on the market increases access to innovative EVV solutions.
Higher costs: The implementation and upkeep of the EVV system that providers have selected may come with a hefty cost.
Data inconsistencies: Variations in data standards and format across multiple EVV systems can make data analysis and sharing more difficult.
3. State-selected in-house system
For this model, the state develops, operates, and manages its own EVV system. The administrative burden and costs of implementing the electronic verification system falls entirely on the state.
Pros
Control: The state maintains complete authority over the EVV system while making sure the software guarantees compliance with state and federal requirements.
Potential cost savings: Any software maintenance needed is done in-house, which results in long-term cost savings.
Data security: To safeguard private patient information, states can include ehanced security measures within their EVV solution.
Cons
High upfront costs: Developing and implementing an in-house EVV system can be expensive.
Ongoing maintenance: Maintaining and updating the system requires ongoing resources and expertise.
4. Hybrid model
This model provides healthcare organizations with two options. They can either opt for the state provided single vendor at no cost or choose their own preferred EVV vendor and cover the expenses. If they select their own vendor, their data must integrate with the state's EVV aggregator.
Pros
Flexibility: Providers can choose between a state-provided system or their own preferred vendor.
Cost savings: Providers can potentially save money by using the state-provided system at no cost.
Data integration: The requirement for data integration with the state's data aggregator ensures consistency across the system.
Cons
Complexity: Managing both state-provided and vendor-selected systems can be complex.
Increased administrative burden: Providers may engage in additional administrative tasks related to data integration.
5. Managed care plan (MCP)
Under this model, managed care plans select EVV vendors of their choice. They are expected to cover the costs of implementing the EVV system.
Pros
Versatility: MCPs can choose EVV vendors that best meet their specific needs and those of their providers.
Cost control: MCPs can negotiate favorable terms with vendors to control costs.
Integrated care: MCPs can integrate their EVV solution with other care management systems to improve overall care coordination.
Cons
Potential for variations: Different MCPs may choose different EVV vendors, leading to variations in the systems used by providers.
Cost concerns: MCPs may face challenges in managing the costs associated with EVV implementation and maintenance.
EVV requirements by state
Among the different EVV models, the Provider Choice and Hybrid Models are quite popular due to their flexibility and balance of control versus choice. Because the requirements for implementing EVV systems and solutions vary by state, we’ve compiled a list of the states and which EVV model they use below.
EVV Model and Aggregator
Find Your EVV Model and Aggregator
Last updated: September 2024
State
EVV Model Choice
Alabama
Open EVV Model
Alaska
Hybrid Model (Therap)
Arizona
Hybrid Model (Sandata)
Arkansas
Hybrid Model (AuthentiCare)
California
Open EVV Model (CalEVV/Sandata)
Colorado
Hybrid Model (Sandata)
Connecticut
Hybrid Model (Sandata)
Delaware
Hybrid Model (Sandata)
Florida
Hybrid Model (Netsmart Technologies)
Georgia
Hybrid Model (Netsmart Mobile Caregiver +)
Hawaii
Open EVV Model (Sandata)
Idaho
Provider Choice Model
Illinois
Hybrid Model (HHAeXchange)
Indiana
Open EVV Model (Sandata)
Iowa
Managed Care Organization Choice
Kansas
Provider Choice Model (AuthentiCare)
Kentucky
Hybrid Model (currently transitioning from Netsmart to Therap)
Louisiana
Open EVV Model (LaSRS)
Maine
Open EVV Model (Sandata)
Maryland
State Mandated In-House System (LTSSMaryland EVV)
Massachusetts
Open EVV Model (Sandata)
Michigan
Open EVV Model (HHAeXchange)
Minnesota
Open EVV Model (HHAeXchange)
Mississippi
Open Hybrid Model (HHAeXchange and FEI Systems)
Missouri
Open EVV Model
Montana
Open EVV Model (Netsmart)
Nebraska
Open EVV Model (Netsmart)
Nevada
Hybrid Model (AuthentiCare®)
New Hampshire
Open EVV Model (AuthentiCare®)
New Jersey
Open EVV Model (HHAeXchange)
New Mexico
State Mandated External Vendor (AuthentiCare)
New York
Provider Choice
North Carolina
Hybrid Model (Sandata)
North Dakota
Open EVV Model (Therap)
Ohio
Open EVV Model (Sandata)
Oklahoma
Open EVV Model (AuthentiCare)
Oregon
Provider Choice
Pennsylvania
Open EVV Model
Rhode Island
Hybrid Model (Sandata)
South Carolina
State Mandated External System (AuthentCare - implementation partially postponed)
South Dakota
Open EVV Model (Therap)
Tennessee
Hybrid Model (Sandata/PPL/Therap)
Texas
Hybrid Model (HHAeXchange)
Utah
Provider Choice Model
Vermont
Open EVV Model (Sandata)
Virginia
Provider Choice Model
Washington
Provider Choice Model
West Virginia
Open/Hybrid Model
Wisconsin
Open Vendor Model (Sandata)
Wyoming
Open Vendor Model (CareBridge)
What is EVV compliance?
Healthcare agencies that are EVV compliant adhere to the Electronic Visit Verification (EVV) regulations set by the Centers for Medicare and Medicaid Services (CMS). These regulations require home health agencies and hospice providers to electronically verify that visits with patients have taken place and have been thoroughly documented.
As we mentioned above, each state may have different requirements that healthcare organizations should follow. Non-compliance with EVV requirements can result in penalties and fines, as well as a loss of Medicare and Medicaid reimbursement. To prevent the consequences of non-compliance from occurring, it is important for home health agencies and hospice providers to understand and comply with EVV regulations.
How Timeero can help with EVV compliance
Timeero is a GPS time-tracking app that can be used as an EVV solution to help you comply with federal and state regulations. Some key features of the software include:
GPS tracking to verify caregiver location
The GPS tracking capabilities of Timeero offer healthcare organizations and agencies an additional degree of transparency. When a caregiver clocks in or out, Timeero automatically records their exact location.
Timeero's "Who's Working" dashboard shows every working employee's location in real time. This feature enables agencies to swiftly identify and assign the closest caregivers to patients experiencing an emergency.
Automated time tracking for accurate billing
EVV requirements necessitate the recording of hours worked by caregivers, and Timeero is an effective solution for this. The app automatically starts to track and records an employee’s work hours, as well as the starting and ending locations of shifts.
Caregivers can easily clock in and out with Timeero’s mobile app.
Your caregivers can download Timeero on a phone or tablet through the Apple App Store or Google Play Store.
Face recognition for patient safety
Home care agencies and healthcare organizations can benefit from Timeero's facial recognition feature in a number of ways. This feature stops buddy punching by using biometric scanning to confirm an employee's identity against their profile photo before allowing them to clock in or out.
Caregivers using facial recognition technology must verify that they are the authorized personnel assigned to that shift, which adds an additional degree of security for patients.
Electronic signatures for an added verification layer
Caregivers can electronically sign their timesheets by using Timeero's electronic signatures feature to confirm they were present and finished their tasks for the day. At the end of their shifts, workers are prompted to digitally sign their timecard.
Electronic signatures for an added verification layer with Timeero
Clients are given the option to sign timecards to confirm that the designated caregiver was present and provided care on that particular day.
Simplified reporting and compliance documentation
Timeero allows you to generate custom reports in a number of ways. Below are some of the filters you can apply to customized reports.
Report by job
Report by user or group
Report by date range
Report by totals only
Week totals
Report by mileage
Breaks report
Scheduled vs. hours worked
Daily flat rate by user
Daily flat rate by total
Daily sign-offs report
Reports provide managers and directors with details they need to verify patient visits. Additionally, reports can be used as evidence of compliance if your company faced a dispute or threat of legal action.
Simplified reporting and compliance documentation with Timeero
Use Timeero to simplify EVV Compliance
Timeero can simplify the EVV compliance process for healthcare providers, ensuring adherence to state requirements. Its accurate time tracking and detailed reports significantly reduce administrative burden and help you focus on patient care.
Having a hard time staying compliant with state EVV regulations?
Emily Maina is a tech-savvy writer with a passion for creating content. With years of experience in the industry, she is well-versed in the latest trends and developments in the tech industry. When she’s not working, Emily enjoys exploring the great outdoors or watching her favorite shows.
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