About Electronic Visit Verification (EVV)
- EVV was successfully implemented for HCBS direct-care services delivered outside of the home on March 1, 2016 through the prior authorization data contractor, Statistical Resources, Inc. These services include the center-based, vocational and transportation services. The web-based EVV solution for these services is accessed and utilized from any device that is able to access the internet including PCs, smart phones and tablets of all types and carriers. This solution allows us to detect when two providers claim to provide services to the same client at the same time. While center-based services account for less than 13% of all services, they are involved in 97% of all client overlapping incidents.
- H.R.34, the 21st Century Cures Act, was signed into law on December 13, 2016. This law requires that all states implement an Electronic Visit Verification (EVV) system for Medicaid-funded Personal Care Services by January 1, 2019 or the Federal medical assistance percentage shall be reduced for these services. Sec. 12006 Electronic visit verification system required for personal care services and home health care services under Medicaid applies to personal care service under HCBS:
The term ‘electronic visit verification system’ means, with respect to personal care services or home health care services, a system under which visits conducted as part of such services are electronically verified with respect to:
(i) the type of service performed;
(ii) the individual receiving the service;
(iii) the date of the service;
(iv) the location of service delivery;
(v) the individual providing the service; and
(vi) the time the service begins and ends.
- During fall of 2016, the Division of Administration approved a sole-source request to include EVV for in-home services in the existing prior authorization data contract with Statistical Resources, Inc. (SRI). This approval was based on the joint conclusion of the Louisiana Department of Health (LDH) and the Division of Administration/Office of Technology Services (DOA/OTS) that there is no contractor other than SRI that can currently meet the state’s need for an EVV system with the capacity for automated billing of EVV services. While there are numerous EVV systems that provide a clock-in/clock-out solution, none of the many EVV systems presented to LDH demonstrated an off-the-shelf solution for automated billing of EVV services. Through the EVV procurement process LDH learned that an automated billing solution can only be accomplished following extensive and timely customization activities.
- LDH is in the process of implementing its EVV system with in-home providers. EVV is being implemented through a regional phase-in process across the state. By using a phased approach, LDH is able to collect practical feedback from participating providers that may be used to address any system or usability issues as they are identified. This has been helpful in facilitating a smooth transition to EVV and the statewide transition is expected to be completed by March 2018.