Providers Scramble To Figure Out Electronic Visit Verification (EVV)

COVID-19 has been at the forefront for most home-based care providers when it comes to clinical and operational activities.

It's easy to forget about new federal technology regulations, such as electronic visit verification (EVV), while the public health emergency is on everyone's attention.

Medicaid-reimbursed home care providers will have to electronically authenticate the services they give in the field beginning January 1st of next year. Data points such as date, time, location, service type, and other information must be recorded by caregivers.

Some Medicare-certified home health care providers will not be required to do so until January 1, 2023. Meanwhile, for home health, some states are mandating it sooner.

The 21st Century Cures Act passed EVV in 2016, with the purpose of preventing fraud and abuse in the delivery of home-based care. The legislation establishes federal rules for EVV, but states are responsible for enforcing the obligation.

States that do not comply with the EVV requirements by the January 1 deadline will have their Federal Medical Assistance Percentage funding reduced, which will have an effect on state program resources.

In some respects, it's understandable that some providers have pushed the deployment of EVV to the back burner.

EVV adoption was originally scheduled to begin on January 1, 2020, which would have been this year. Instead, the majority of states, including New York, sought for and were granted exclusions, delaying implementation by a year.

According to Emina Poricanin, managing attorney of New York-based Poricanin Law, "New York state received multiple petitions to postpone the implementation due to the difficulty in rolling this out in the personal care business." "Those have been approved." The state of New York did not have the power to just postpone it unilaterally."

According to Poricanin, some providers are feeling unprepared around two weeks before they are supposed to be in conformity with the legislation.

"To this day, there are simply too many providers contacting me what is EVV and what I need to do about it," she added. "At this stage in the game, they are extremely late questions."

Courtney Martin, EVV specialist for technology solutions vendor CellTrak, told HHCN that states also play a role in overall industry preparation.

"It depends a lot on the state implementation strategy in your area...." "Some states have been ahead of the curve in terms of implementation, and they've already provided a lot of information to their providers about expectations and how they'll be judged against them," Martin said. "It's been done in around half of the states. Then there are certain states where implementation is taking a little longer."

CellTrak, situated in Schaumburg, Illinois, provides home-based care solutions to over 4,000 home care companies throughout the world, including EVV.

When it comes to the mandate, providers must fulfill two roles. In the field, at the point of care, they must gather accurate, compliant EVV information. Furthermore, providers must provide such information to the state or the managed care organization that needs it for compliance.

As a result, any technological solutions a provider has in place, according to Martin, must assist them in doing this.

To this aim, providers may use either a state-provided or a commercially offered EVV system.

Martin said, "Those judgments are obviously highly specific to the suppliers." "In general, the state system will have a relatively simple check-the-box compliance." Some providers may opt for the free option if they are seeking to achieve the minimal requirement."

According to Martin, this might be a problem for multi-state suppliers.

"The disadvantage of a free solution is that if you operate in numerous states, each of which has its own free solution," she said. "Now, the agency is attempting to assist caregivers in receiving training and monitoring for these various state solutions."

Providers should think about their operational process as well as state compliance requirements when choosing a technological solution.

Martin emphasized the need of providers starting the data gathering and documentation process as soon as possible, as the EVV implementation date approaches.

"Rather than waiting for governmental instructions," she added, "we urge providers to do it." "The reason for this is that their caretakers need to get used to the technological solution. It allows them to consider how their internal agency workflow will be affected after their EVV procedures are implemented. It also allows them to plan ahead for when the state advice is issued."

To keep current with fresh information, providers should attend state stakeholder meetings.

For example, for the last several months, the state of New York has conducted weekly calls. The purpose of the conversations, according to Poricanin, was to assist providers in getting ready for EVV and to resolve some of the technical challenges that may arise.

Martin thinks that EVV adoption will enhance care delivery while clinicians continue to function in the midst of the public health emergency.

"You'll have a lot more knowledge about that patient — and the treatment that they need," she said. "This may help you perform a better job during the visit and also alert you to any special situations you should be aware of, such as the patient's possible susceptibility to COVID-19 exposure."