Section 12006 of the 21st Century Cures Act (the Cures Act) requires that the North Carolina Department of Health and Human Services (NCDHHS) begin using an Electronic Visit Verification (EVV) system for Home Health Care Services (HHCS).
In compliance with the Cures Act, NC Medicaid has determined that the following services covered through the State Plan and Clinical Coverage Policy 3-A Home Health will be subject to the EVV requirement:
- Home Health Aide Services
- Physical Therapy
- Occupational Therapy
- Speech Therapy
- Skilled Nursing Visits
EVV will verify:
- Date of service
- Beneficiary receiving services
- Location of service
- Person providing service
- Type of service rendered
- Time the service begins and end
Soft Launch Expectations
The soft launch pay and report period for this implementation began April 1, 2023. During the soft launch period from April 1, 2023, to June 30, 2023, home health claims will pay without a verified visit containing all required EVV data.
Effective immediately, it is expected that all providers use the EVV vendor of their choice for every home health visit. Section 7.8 of the Home Health Clinical Policy outlines the EVV requirements for those services subject to EVV. As of April 1, 2023, home health providers who are not connected to an EVV vendor and capturing the required EVV data elements are out of compliance with the EVV requirements noted in the Home Health Clinical Policy.
NC Medicaid is monitoring provider readiness and adoption closely. Regular reports of submitted visits, both verified and incomplete, are being tracked to ensure compliance. Staff is reaching out via phone calls and emails to provide technical assistance and guidance to home health providers not using the system successfully.
It is important that providers carefully select the correct information and submit all the required information for each visit. Many of the submitted visits are missing information and are in an incomplete status. The visit record must match the claim submitted to NCTracks for it to pay beginning July 1, 2023.
Next Steps
If a home health agency has not yet contracted with an EVV vendor, contact Sandata to begin the process.
Continue to review the NCTracks Explanation of Benefits (EOB) to identify any visit issues as the agency refines its processes and to avoid claims impact after soft launch.
Providers with beneficiaries in NC Medicaid Direct needing additional assistance should email Medicaid.evv@dhhs.nc.gov.
Providers with beneficiaries in a health plan needing additional assistance should contact HHAX or CareBridge for assistance.
Training
Sandata is hosting additional training sessions for providers. The registration link and topics are found below.
NC EVV Hot Topics Training Sessions
Sandata has developed Hot Topic Sessions for the North Carolina Home Health Implementation, these sessions will address learning gaps that many providers encounter while becoming familiar with the Sandata EVV system. In these 60-minute sessions, learners can bring related questions to share via chat or voice during the Q and A part of the session. Additionally, these sessions will include a review of training resources for the North Carolina provider community available on Sandata On-Demand.
Hot Topics Session Registration
Please visit the Sandata Webinar Center here to register for any of the training sessions listed below.
Hot Topics Session Dates
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Entering Essential Data for Clients and Employees
- April 20, 2-3 p.m.
- May 16, 2-3 p.m.
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Schedule Visits and Reduce Conflicts
- April 27, 11 a.m.-12 p.m.
- May 18, 11 a.m.-12 p.m.
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Reduce Manual Visits with the Sandata Mobile Connect App
- May 4, 11 a.m.-12 p.m.
- May 23, 11 a.m.-12 p.m.
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Seeing Red Dots: How do I Handle these Expectations?
- May 11, 2-3 p.m.
- May 30, 2-3 p.m.