Electronic Visit Verification (EVV)
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Full EVV compliance is required for dates of service on and after July 1, 2024.
This means:
- All claims that require EVV must have a compliant EVV record and must be submitted via Mobile Caregiver+.
- EVV data must be submitted through Mobile Caregiver+ or a DPHHS-certified alternate EVV solution.
- Claims submitted without compliant EVV data and/or through Mobile Caregiver+ (MT’s aggregator) will be denied for applicable dates of service.
Overview
Electronic Visit Verification (EVV) is a federally mandated requirement under Section 12006 of the 21st Century Cures Act. EVV electronically verifies the delivery of certain Medicaid-funded home and community-based services to ensure services are provided as authorized, accurately documented, and billed appropriately.
The Montana Department of Public Health and Human Services (DPHHS) has fully implemented an EVV solution to support Personal Care Services (PCS), Home Health Care Services (HHCS), and other applicable home and community-based services. DPHHS’s State-provided EVV solution is Netsmart’s Mobile Caregiver+.
What EVV Verifies
EVV electronically captures and verifies the following required elements at the point of care:
- Type of service performed
- Individual receiving the service
- Individual providing the service
- Date the service was provided
- Location of service delivery
- Actual start and end times of the service (recorded in real time on the device)
What Is EVV and Why It Matters
EVV is a technology solution that automates the collection of service delivery information by capturing service start and end times, activities performed, and other required data entered by a home care worker at the point of care. EVV provides near real-time visibility into service delivery to help ensure continuity of care, participant health and safety, and compliance with federal and state requirements. Authorized providers, care coordinators, members and guardians, and DPHHS staff have access to EVV data as appropriate to support care coordination, program oversight, and Medicaid program integrity.
Benefits of EVV
Benefits for Members
An EVV system helps:
- Ensure services are delivered as authorized
- Improve consistency and reliability of care
- Support participant health, safety, and welfare
- Improve communication across the care coordination team
Benefits for Providers
An EVV system helps providers:
- Eliminate paper-based documentation
- Track caregiver activity and service delivery accurately
- Increase flexibility in scheduling and delivering services
- Reduce administrative burden and billing errors
- Automate the collection of information required for claims submission
- Improve quality oversight through transparent, measurable service data
- Reduce the risk of fraud, waste, and abuse
EVV Model
DPHHS uses an Open Vendor EVV model.
- DPHHS provides Netsmart’s Mobile Caregiver+ at no cost to providers who deliver services subject to EVV.
- Providers may use an Alternate EVV Solution if the system meets DPHHS EVV compliance requirements and is certified for use with Montana Medicaid. Alternate EVV Solutions must integrate with Netsmart’s Mobile Caregiver+ to transmit required visit data to DPHHS.
- Please review the Netsmart MT DPHHS website for more information about alternate EVV vendor integration and implementation.
New to EVV?
If you are new to EVV, please review the EVV Quick Start Guide, which outlines the steps needed to achieve and maintain compliance.
Contact Us
For general help or to ask questions, contact us at EVVQuestions@mt.gov.
Subscribe for Updates
Register your email address to receive EVV updates and notifications in your In Box.
When the window opens, enter your email address, and select the Submit button.
To access your subscriber preferences, enter a previously registered email address and choose the Submit button. The Already Subscribed message opens.
To view or change preferences or delete the account, click the Subscriber Preferences option, and follow related prompts.
The following list includes Medicaid Providers by Provider Type who have billed Medicaid services subject to EVV in the last 18 months. At a minimum the Department needs all of the Providers listed below to complete the Provider survey as soon as possible.
This is not the complete list of all Providers enrolled by these Provider Types. If you are a Medicaid provider that plans to provide Medicaid services subject to EVV in the future, we encourage you to complete the survey.
- MT Medicaid Providers Billing Services Subject to EVV
DPHHS is updating EVV requirements in preparation for acquiring an EVV solution. We have established a high-level timeline for when Montana’s EVV solution will be available for providers.
The dates below with a tilde symbol ~ designation are estimates and subject to change.
|
Step |
Planned Start Date |
Planned End Date |
|
Update and Finalize EVV Requirements |
06/1/22 |
09/16/22 |
|
Finalize EVV Vendor Selection |
10/07/22 |
|
|
Submit EVV Contract to CMS |
11/22/22 |
|
|
Conduct External Stakeholder Work Group Sessions |
12/12/22 |
12/21/23 |
|
Receive CMS Approval for EVV Contract |
|
12/29/22 |
|
Kick-off EVV Project |
01/10/23 |
|
|
Conduct Monthly Stakeholder Town Hall Sessions |
01/25/23 |
08/30/23 |
|
Implement EVV Application |
09/18/23 |
|
|
Provider Full Compliance for EVV |
|
7/1/24 |
- General Questions
- MT EVV Self Direct Workflow
- Self-Direct Vendor Questions
- External Stakeholder Presentation - August 23, 2023
- External Stakeholder Presentation - July 19 2023
- External Stakeholder Presentation - June 14, 2023
- External Stakeholder Presentation - May 17, 2023
- External Stakeholder Presentation - Apr. 19, 2023
- External Stakeholder Presentation - Mar. 14, 2023
- External Stakeholder Presentation - Dec. 14, 2022
21st Century Cures Act
CMS Informational Bulletins
- Additional EVV Guidance – August 8, 2019
- Cures Act for Electronic Visit Verification – May 16, 2018
Conference Presentations
- EVV Requirements in the 21st Century Cures Act: NASUAD Pre-Conference Intensive – August 2018
- EVV Requirements in the 21st Century Cures Act: NASUAD Conference Workshop – August 2018
- Section 12006 of the 21st Century Cures Act Electronic Visit Verification Systems Session 2: Promising Practices for States Using EVV – January 2018
- Section 12006 of the 21st Century Cures Act Electronic Visit Verification Systems Session 1: Requirements, Implementation, Considerations, and State Survey Results – December 2017
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