Electronic Visit Verification

As required by Section 12006 of the 21st Century Cures Act, the North Carolina Department of Health and Human Services (DHHS) will implement an Electronic Visit Verification (EVV) system for Personal Care Services (PCS) by January 2019 and for Home Health Care Services (HHS) by January 2023.

What is EVV?

EVV is a method used to verify visit activity for services delivered as part of home- and community-based service programs. EVV offers a measure of accountability to help ensure that individuals who are authorized to receive services in fact receive them.

If you are a provider, please complete this quick survey about EVV

Announcements

June 24, 2020 EVV RFP Released
On June 19, 2020, the Department of Health and Human Services, Division of Health Benefits has issued the Electronic Visit Verification Request for Proposals.
Nov. 27, 2019

EVV Good Faith Effort Exemption
On Nov. 21, 2019, the Centers for Medicare and Medicaid Services (CMS) granted approval of North Carolina’s EVV good faith effort exemption request. Approval of the Good Faith Effort Exemption allows NC Medicaid until Jan. 1, 2021, to be fully compliant with implementation of EVV per the 21st Century Cures Act (Cures Act). NC Medicaid is planning to resume Stakeholder Engagement and a list of meeting dates and engagement opportunities will be available on this webpage. Stay tuned.   

Oct. 28, 2019

EVV Good Faith Effort Exemption
Question: Will NC request a Good Faith Effort Exemption to delay EVV implementation through Jan. 1, 2021?
Answer: Yes, NC submitted a Good Faith Effort Exemption Request to CMS on Oct. 23, 2019. Stakeholder Meetings will resume once we receive a response from CMS. 

Outcomes-based Certification for EVV Systems
On Oct. 24, 2019, CMS released an Information Bulletin describing refinements made to the existing certification process as they apply to EVV systems used for all Medicaid personal care services and home health services requiring an in-home visit by a provider. The Cures Act authorized enhanced federal financial participation for EVV systems, which are therefore subject to the federal regulations 42 CFR § 433.112(b) —Mechanized Claims and Processing Information Retrieval Systems. For more information visit https://www.medicaid.gov/federal-policy-guidance/downloads/cib102419.pdf
 

Aug. 29, 2019

EVV Good Faith Effort Exemption
NC Medicaid is in the process of developing our request for a Good Faith Effort Exemption from CMS. Approval of the Good Faith Effort Exemption allows states to delay implementation of EVV through January 1, 2021. Medicaid will update the EVV website with the CMS response once received. NC intends to implement EVV (State Plan PCS and Waiver PCS) for both Medicaid FFS (Medicaid Direct) and Managed Care, at one time.

As we prepare for implementation and develop a tentative timeline, we will consider the possibility of initiating a voluntary EVV pilot program prior to Go-Live. Medicaid will reconvene the previous EVV Stakeholder group once the Good Faith Effort Exemption has been submitted to CMS. The target date for submission is late September. If you have additional questions regarding EVV, please email Medicaid.EVV@dhhs.nc.gov.

For more information on the Good Faith Effort Exemption Request Process, view "EVV Update: Requests from States for Good Faith Effort Exemptions."    

Please stay tuned to this webpage for more information on EVV as we move towards implementation.

Resources

EVV Flyer

Centers for Medicare & Medicaid Services (CMS) EVV Presentation - Part 1

Centers for Medicare & Medicaid Services (CMS) EVV Presentation - Part 2

Centers for Medicare & Medicaid Services (CMS) Informational Bulletin - May 16, 2018

Centers for Medicare & Medicaid Services (CMS) Informational Bulletin - Frequently Asked Questions - EVV

Long-Term Services & Supports (LTSS) / Home- and Community-Based Programs

Community Alternatives Program for Children (CAP/C)

Community Alternatives Program for Disabled Adults (CAP/DA)

Money Follows the Person

NC Innovations

Personal Care Services

Contact

Email: Medicaid.EVV@dhhs.nc.gov

Short web address: medicaid.ncdhhs.gov/evv

Archive

2018 Announcements

2018 Announcements

Aug. 16, 2018

EVV Delay
HR 6042, legislation to delay the implementation date of EVV by one year, was signed into law on July 30, 2018. The legislation makes the following changes to the EVV requirements in the Cures Act:

  1. Changes the implementation date for EVV for personal care services to Jan. 1, 2020;
  2. Changes the time during which a state can get a good faith exemption from implementing the requirements for personal care services to calendar quarters in 2020; and
  3. Expresses the sense of Congress that CMS should:
    A. Convene at least one public meeting in 2018 for the purpose of soliciting ongoing feedback from Medicaid Stakeholders on guidance issued by the Centers for Medicare and Medicaid Services on May 16, 2018, regarding electronic visit verification; and
    B. Communicate with such stakeholders regularly and throughout the implementation process in a clear and transparent manner to monitor beneficiary protections. 
Aug. 16, 2018 EVV not required for Personal Care Services in residential settings.
CMS has provided the below response to NC Medicaid in regards to EVV implementation in residential settings:
Because the services you described are delivered in a congregate residential setting rendering shift-based, 24 hour services, CMS has determined that EVV requirements do not apply to services delivered in this setting.
 
Aug. 16, 2018 Request for Information (RFI)
NC Medicaid is preparing to issue a RFI to survey the market place for potential vendors of an Electronic Visit Verification System. Medicaid is seeking to utilize the Open Vendor Model concept to meet the EVV requirements of the Cures Act.