Electronic Visit Verification

This brief shares data on state policy choices about Medicaid HCBS, including target populations, functional eligibility criteria, financial eligibility criteria, waiver waiting lists, benefit packages, out-of-pocket costs, use of capitated managed care, self-direction opportunities, covered provider types, electronic visit verification systems, and provider reimbursement rates.

CMS released a bulletin addressing frequently asked questions regarding Electronic Visit Verification (EVV) requirements to beneficiaries receiving in-home care. This bulletin responds to questions surrounding beneficiaries with live-in caregivers, services delivered partially in the beneficiary's home, the provision of medical supplies, equipment, and appliances as a component of the Medicaid home health benefit, and the use of web-based timesheets as an EVV method.

CMS has released a notice with information about the process for states to apply for a “good faith effort” (GFE) exemption, which provides up to one year of extra time to come into compliance with Electronic Visit Verification.

This brief outlines successful EVV implementation in self-direction. Successful implementation is defined as one that protects and upholds the participant's choice and control over their services and supports while strengthening program integrity. The brief describes the functionality required to support self-direction, including flexible scheduling, protocols for EVV system use in areas without internet access, and workflows that support participant control of workers' hours.

This report describes key considerations and policy decisions that states should consider as they work to implement EVV systems in accordance with the mandate included in the 21st Century Cures Act. The paper also examines different approaches that states may wish to use to establish EVV within their HCBS programs, and discusses some of the benefits and challenges associated with each approach. Lastly, it includes case studies of four states with existing EVV systems.