March 26, 2020: EVV delay
In response to the COVID-19 pandemic, the Wisconsin Department of Health Services is delaying the start of training and the soft launch date (formerly September 1, 2020) requirement to use EVV for personal care services. We will announce a new timeline when it is available.
What is EVV?
EVV is an electronic system that uses technologies to verify that authorized services were provided. Workers will be required to send information at the beginning and end of each visit to an EVV system, including:
- Who receives the service
- Who provides the service
- What service is provided
- Where service is provided
- Date of service
- Time in/time out
NEW! Policy decisions
The Centers for Medicare & Medicaid Services (CMS) issued states additional guidance on Electronic Visit Verification requirements. CMS provided states the flexibility to decide if live-in workers and services rendered in the community are subject to EVV requirements.
DHS policy decisions
- DHS is not requiring EVV for live-in workers.
- DHS will require EVV for services regardless of where the services are provided, whether in the community, in the home, or both.
- Managed care organizations (MCOs), health maintenance organizations (HMOs), and provider agencies may independently decide, based on business needs, if their live-in workers are required to use EVV.
- IRIS Fiscal Employer Agents (FEAs) cannot require participant-hired live-in workers to use EVV.
Definition of a live-in worker
For the purposes of Wisconsin EVV, a live-in worker is a worker who permanently resides in the same residence as the Medicaid member receiving services. Workers who do not meet this definition are not considered live-in workers. Live-in worker status must be established between each member and worker. When a live-in worker provides services to more than one member with whom they permanently reside, live-in worker status must be validated for each member.
Live-in worker examples:
- Workers who live with the Medicaid member receiving services for only a short period of time, such as two weeks, are not considered live-in workers.
- Workers who work 24-hour shifts, but are not residing with the Medicaid member "permanently," are not considered live-in workers.
NEW! Public forum materials
This requirement affects all personal care and home health services, including services provided through:
- Medicaid and BadgerCare Plus fee-for-service (ForwardHealth card)
- BadgerCare Plus and Medicaid SSI HMOs
- Family Care and Family Care Partnership
- IRIS (Include, Respect, I Self-Direct)
DHS will work to:
- Maintain services provided, including community integration.
- Support provider selection.
- Keep an individual’s choice of a worker.
- Ensure needed care is delivered.
- Ensure data is secure and compliant with the Health Insurance Portability and Accountability Act (HIPAA).
Please download and share our EVV handout. It is available in six languages, provides a broad overview of EVV, and includes our continued commitment to quality services.
Input from our stakeholders is essential to the successful implementation of EVV. Questions and comments can be sent to the EVV email or to: Division of Medicaid Services, Attention: Electronic Visit Verification, PO Box 309, Madison, WI 53707-0309
Pursuant to Section 12006(a) of the 21st Century Cures Act, which mandates that states implement EVV for all Medicaid personal care services that require an in-home visit by a provider