Electronic Visit Verification (EVV): Read the FAQ

Questions received

The following FAQ is a list of questions the Wisconsin Department of Health Services (DHS) has received from stakeholders through public forums, the dhsevv@dhs.wisconsin.gov email box, and the Wisconsin EVV Advisory Council.

This page includes frequently asked questions and answers about the EVV requirement and will be revised with new information as it becomes available. The questions at the bottom of the FAQ will be answered once decisions are finalized.

 

Overview

What is EVV?

EVV is an electronic system that uses technology to verify that authorized services were provided. Workers will be required to send information to an EVV system at the beginning and end of each visit, including:

  • Date of service.
  • Time of service.
  • Location of service.
  • Service type.
  • Individual providing the service.
  • Individual receiving the service.

Why implement EVV?

The federal 21st Century Cures Act requires states to implement an EVV requirement for Medicaid-covered personal care services and home health services.

DHS is implementing EVV to be in compliance with the federal 21st Century Cures Act.

What is the federal 21st Century Cures Act?

Section 12006(a) of the 21st Century Cures Act mandates that states implement EVV for all Medicaid personal care services and home health services that require an in-home visit by a provider. This applies to personal care services provided under sections 1905(a)(24), 1915(c), 1915(i), 1915(j), 1915(k) and Section 1115, and home health services provided under Section 1905(a)(7) of the Social Security Act or a waiver.

States must require EVV use for all Medicaid-funded personal care services by January 1, 2020, and all Medicaid-funded home health services by January 1, 2023. Otherwise, the state is subject to funding reductions up to 1% unless the state has made both a “good faith effort” to comply and has encountered “unavoidable delays.”

What programs does EVV affect?

EVV affects all personal care and home health services, including services provided through Wisconsin Medicaid and BadgerCare Plus fee-for-service, BadgerCare Plus HMOs (health maintenance organizations), Medicaid SSI HMOs, Family Care, Family Care Partnership, IRIS (Include, Respect, I Self-Direct), and Katie Beckett.

When will EVV be implemented?

The federal 21st Century Cures Act requires states to implement EVV for personal care services by January 1, 2020, and home health services by January 1, 2023. DHS is working to meet this date and will continue to listen to stakeholders’ needs in establishing our timeline.

Will workers be assigned a unique identification number for EVV?

Yes. EVV requires us to identify the individual providing services. Assigning a unique ID protects the workers personally identifiable information within the EVV system. DHS is working on a plan to assign IDs to workers.

How can I provide my feedback?

You can contact DHS by emailing dhsevv@dhs.wisconsin.gov.

How will DHS engage with stakeholders?

DHS has created an EVV Stakeholder Engagement Plan that will be reviewed and updated based on the needs of the project and input from stakeholders. The plan consists of:

  • Provider Agency Workgroup—began meeting in 2017
  • Provider Agency Survey—completed in August 2018
  • Member, participant, caregiver, and association forums in various statewide locations and online. 
  • HMO, MCO (managed care organization), and IRIS administrator meetings—to be held as needed throughout planning and implementation
  • Wisconsin EVV Advisory Workgroup—kickoff held on November 15, 2018, and monthly meetings to be held throughout the life of the project

Has DHS researched how other states implemented EVV?

Yes, DHS has contacted numerous states to discuss how they have implemented EVV. DHS is also participating in meetings where states discuss their EVV implementation designs and lessons learned.

Member and participant questions

Can we stop EVV from being implemented in Wisconsin?

No. Section 12006(a) of the 21st Century Cures Act mandates that states implement EVV for all Medicaid personal care services and home health services that require an in-home visit by a provider.

Provider agency, worker and association questions

Who is the EVV vendor in Wisconsin?

On November 19, 2018, DHS announced that our current Medicaid Management Information System (MMIS) fiscal agent, DXC Technology, selected Sandata Technologies as the EVV vendor. DHS made this decision to optimize integration with the current MMIS.

Will providers be required to use Sandata’s EVV technology?

DHS will use Sandata’s aggregator technology to implement EVV, which allows providers who already have an EVV system to continue to use it if it meets EVV and DHS aggregator use requirements. The aggregator merges the data from the existing system into the Sandata system.

What third party systems does the Sandata aggregator work with?

The Sandata aggregator will be available for anyone to use as long as the technical requirements are met. Technical specifications are forthcoming. 

Will Sandata Technologies be allowed to charge impacted providers, HMOs, MCOs (managed care organizations), or IRIS program administrators for use of the EVV system?

No.

Will impacted providers need to purchase an EVV system?

No.

What technologies will be available to submit visit verification information?

  • Sandata Mobile Connect (MC)—a mobile application to collect visit information
  • Sandata Telephonic Visit Verification (TVV)—uses automatic number identification (ANI) technology to validate phone calls from the member’s identified phone number(s) and collection visit information
  • Sandata Fixed Visit Verification (FVV)—a patented technology alternative to verify visits when no landline or cellular service is available
  • Sandata EVV Aggregator—allows providers to continue to use a third-party EVV system as long as it meets EVV and DHS aggregator use requirements

Do agencies need to pay the state to use the EVV system being provided?

No. Agencies will not pay for use of the state-provided EVV system; however, agencies should expect to incur some costs for the training and setup of the state-provided system.

Will providers be financially impacted by the implementation of EVV?

The 21st Century Cures Act requires the implementation of EVV to be “minimally burdensome.” Minimally burdensome does not mean it will have no impact, but DHS will work to minimize impact when possible. DHS will collaborate with stakeholders to ensure these changes have the least amount of financial impact on members, participants, caretakers, and providers while still meeting federal requirements.

Does Sandata have a mobile app for EVV?

Yes. DHS will work with Sandata to configure its existing mobile application for Wisconsin’s needs.

Do workers who work split shifts have to clock in/out twice?

Yes, workers will clock in and clock out at the beginning and end of each shift. This includes split shifts.

What level of detail must be included in the "Type of Service" field when clocking in?

Caregivers will select a service from a drop down menu on the mobile app or enter a service code over the phone. Future training will discuss this further.

Will EVV track workers who work for multiple agencies?

Each worker will be assigned a unique ID that will be recognized regardless of the agency for which they are working.

What language options are available through the Sandata Portal and other applications?

The app and telephone visit verification will offer 15 language options including those most frequently utilized in Wisconsin. Workers and those receiving care can set their language preferences separately. Choices include English, Hmong, Laotian, Burmese, Spanish, French, Russian, Serbian, Somali, Swahili, Arabic (Egyptian), Hindi, Chinese (Mandarin), Nepali, Vietnamese.

The agency portal will be available in English.

How quickly will visit information be available in the Sandata portal?

Information from visits will be updated in the Sandata Portal in near real time. Information from 3rd party vendors through the Sandata aggregator will be updated frequently, but the frequency will depend on the vendor.

Where can I see a Sandata system demonstration?

Follow this link to the April 2019 EVV forum. The Sandata system demonstration begins at the 30 minute mark. 

Will there be training on how to use the mobile app?

Yes, user training will be available before EVV implementation.

Who is responsible for training agency workers to use EVV?

DHS will implement a robust training plan. The details of the training plan, including who will train workers, are still being decided. A final training plan will be communicated to agencies.

Does the EVV GPS monitor a worker at all times, including before and after work?

The technology used to verify the worker’s location only records locations at the start and stop of the service. It does not record location at any other time.

Can EVV be used for services outside the home?

Yes, EVV can be used for community visits and services provided outside of the home.

Will the Children’s Long-Term Care Services (CLTS) waiver program be required to implement EVV for personal care services by the January 2020 effective date?

Yes. EVV will be required for personal care services received through the fee-for-service card benefit beginning January 2020, and personal care services in the CLTS waiver benefit package are transitioning to the fee-for-service card benefit effective January 1, 2020.

Will natural or unpaid supports (unpaid help and care that someone receives from their friends, family, or community) be required to use EVV?

No. EVV is for services paid for with state Medicaid dollars. EVV is not applicable to unpaid support.

Program administrator (HMO, MCO [managed care organizations], fiscal employer agents) questions

How can HMOs, MCOs, and fiscal employer agents submit questions?

You can contact DHS by emailing dhsevv@dhs.wisconsin.gov.


Working to answer in the near future

DHS received the following questions, and they will be answered once decisions are finalized.

Overview Questions

Will EVV be implemented statewide simultaneously?

Member and Participant Questions

Will the member or participant need to use EVV to verify that services were received?

Provider Agency, Worker, and Association Questions

  • When will the mobile app be available?
  • Where does the information from the EVV system go?
  • Will EVV change how claims are submitted or processed?
  • Will DHS deny payment for claims that do not have corresponding EVV data?
  • Will the implementation of EVV require any regulation changes?
  • What services will require EVV?
  • What will the process be for clocking in and out for EVV?
  • What billing codes are affected by EVV?
  • Will the DHS EVV system incorporate scheduling, billing, or other modules?

 

 

Last Revised: September 22, 2019