Virginia Medicaid
Menu

Electronic Visit Verification


Overview

For the most recent information on Electronic Visit Verification (EVV), please review the updated Frequently Asked Questions document.

We want to hear from our providers now that these rules are in place. What is working? What areas need improvement going forward? To share your feedback or ask additional questions about EVV, please email EVV@dmas.virginia.gov.


The federal 21st Century CURES Act of 2016 requires states to implement EVV. Subsequent legislation extended the deadline for states to comply with the EVV requirement for Medicaid personal care services to January 1, 2020. There was no change in the date for home health services: January 1, 2023. DMAS has applied for a Good Faith Extension and is working toward a July 2023 implementation for Home Health Care Services (HHCS) EVV.

The Virginia Appropriations Act expanded the use of EVV to include consumer-directed personal care and respite and companion services.


Benefits

There are several benefits to adopting an EVV system:

  • Promote quality outcomes for individuals (Quality of Care)
    • Greater opportunity for enhanced care coordination and data sharing.
  • Reduce billing errors and improve payment accuracy (Program Integrity)
    • Electronically verifies that a caregiver is physically present for a visit.
  • Promote oversight of the services provided
    • Comply with federal and state requirements.

 



Virginia Health Plans

Electronic Visit Verification Documents from Virginia Health Plans

Aetna

Anthem

Magellan

OptimaHealth

United Healthcare





Beneficiary & Caregiver

The individual receiving services and supports and the caregiver should be informed about EVV. Foremost, EVV provides a level of assurance the caregiver is onsite to provide the services identified in the plan of care. This is a useful tool to reduce fraud, waste and abuse which promotes the integrity of the service. Additionally, your provider may have specific requirements that may involve the member or caregiver.

Vendors

Vendors are encouraged to review the two links about the Companion Guides above along with the FAQs and the Draft EVV Regulations.

Contact

For additional questions about Electronic Visit Verification (EVV)

Regulations

The EVV regulations went into effect on August 18, 2021. They are available at 12VAC30-60-65 Electronic Visit Verification. They will be updated to include EVV requirements for Home Health Care Services.