Electronic Visit Verification (EVV) Project & Personal Care Attendant (PCA) Enrollment Requirement


Contact Us

Stephanie Robbins
Social Services Specialist
775-684-3748
pcsprogram@dhcfp.nv.gov

    Listserv

    Provider Types Affected

    • PT30 & 83 : Personal Care Services
    • PT48 & 58 : Attendant Care, Homemaker, Chore, and Respite Services

    Links & Resources

    Request for Proposal (RFP)

    Upcoming

    • Project Kick Off - APRIL 2019
    • Outreach & Training - JUNE & JULY
    • Anticipated Go-Live - AUGUST 2019

    Electronic Visit Verification Project

    In December 2016, Congress passed H.R. 34 - 21st Century Cures Act, mandating that all States require the use of an Electronic Visit Verification system for all Medicaid funded personal care services that are provided under a State plan or a waiver of the plan, including services provided under section 1915(c), 1915(i), 1915(j), or 1915(k) or under a waiver under section 1115. States not requiring the use of an EVV system for such services by January 1, 2019 will see a reduction in the federal funding received. On July 30, 2018, an EVV delay bill was passed (H.R. 6042) to delay the EVV implementation for PCS services to January 1, 2020 without penalty.

      In order to comply with this recently passed federal regulation, the Division of Health Care Financing and Policy, which operates Nevada's Medicaid program and other health benefit programs, has contracted with an EVV system to meet the federal mandate – AuthentiCare® by First Data Government Solutions, LP. The following DHCFP objectives will be addressed with the use of this new 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.

        To receive information regarding EVV, please follow the link below to subscribe to the listserv.

          You will receive information that is timely and relevant to EVV, such as general news, pertinent policy changes, training and education, and various announcements, etc.

          Personal Care Attendant (PCA) Enrollment and National Provider Identifier (NPI) Requirement

          Currently Personal Care Services (PCS) Agencies enroll as Medicaid providers under the following provider types: 30, 48, 58, and/or 83. In order to differentiate between the billing provider (PCS Agency) and the servicing provider (personal care attendants), Nevada Medicaid will be requiring that all personal care attendants (PCAs) obtain a National Provider Identifier (NPI) and enroll as a Medicaid provider under the provider types(s) for which they provide services. This initiative is still on the roadmap, however, there is no actual date of implementation at this time due to the modernization of MMIS – interChange. More information will be released in the upcoming months. Stay tuned!

            The first step to enrollment requires each PCA to obtain a NPI through the National Plan and Provider Enumeration System (NPPES). There is no cost associated with obtaining a NPI. Please note it may take up to three (3) weeks to obtain these numbers. Failure to obtain a NPI could delay payment for services rendered. When the NPI requirement is implemented, the NPI of the PCA will be required on claims. However, the NPI of the PCA is not required for the prior authorization process.