The 21st Century Cures Act signed into law by Congress in December 2016, mandates that all State agencies requires the use of an electronic visit verification system for all Medicaid funded Personal Care Services (PCS) and Home Health Care Services (HHCS) that are provided under a State plan or under a waiver of the plan. In Nevada, EVV is required for State plan PCS and HHCS and certain PCS-like Home and Community Based Waiver Services specific to the Frail Elderly and Physically Disabled.
In order to comply with this federal regulation, the Division of Health Care Financing and Policy (DHCFP), which operates Nevada's Medicaid program and other health benefit programs, has opted for the Open Choice Model. This is a hybrid model where the state contracts with at least one EVV vendor or operates its own EVV system while still allowing providers with existing EVV systems to continue to use those systems. DHCFP has contracted with a vendor to operate Nevada’s EVV system.
The following DHCFP objectives will be addressed with the use the EVV system:
- Ensure timely service delivery for recipients including real time service gap reporting and monitoring.
- Reduce administrative burdens associated with hard copy timesheet processing; and
- Generate cost savings from the prevention of fraud, waste, and abuse.
Electronic Visit Verification is a process that electronically captures details of home visits and services provided by caregivers while ensuring that Medicaid recipients are receiving the support they require, and that rendered services are billed accurately. The EVV system, must at a minimum, verify the following:
- The type of service(s) performed
- The individual receiving the service(s)
- The date of the service(s)
- The location of service delivery
- The individual providing the service(s)
- The time the service(s) begins and ends