Electronic Visit Verification (EVV)

What is EVV?

In December 2016, the 21st Century Cures Act was enacted into law by the 114th United States Congress. Section 212006 of the Cures Act requires all states to implement the use of Electronic Visit Verification (EVV) for Medicaid-funded personal care and home health services that require an in-home and community visit. EVV is a technology solution that electronically verifies the utilization and delivery of care services.

EVV must record information on at least six aspects of service delivery:

The CURES Act requires that EVV systems must collect and verify the following

• The type of service provided.
• The name of the individual receiving service.
• The date of service delivery.
• The location of service delivery.
• The name of the individual providing the service.
• The time the service begins and ends.

Benefits of EVV:

• Reduces the need for paper documentation.
• Flexibility in scheduling and delivering services.
• Improves participant health and safety monitoring.
• Minimize potential for fraud, waste and abuse (FWA).

Services In Scope

Providers must comply with the EVV requirements in accordance with the Pennsylvania Department of Human Services (DHS) for Pennsylvania Medicaid Recipients. The 21st Century Cures Act requires electronic verification of visits for Medicaid-funded personal care services and home health care services before they can be paid by PA-DHS.

DHS RESOURCES:

• DHS PA Electronic Visit Verification (EVV)
• DHS Home Health Codes Subject to EVV

HHAEXCHANGE RESOURCES

Highmark Wholecare transitioned to HHAeXchange as our payer-sponsored Electronic Visit Verification (EVV) system as of 11/1/2024. HHAeXchange will serve as the EVV platform for Highmark Wholecare’s Pennsylvania Medicaid Physical HealthChoice's recipients.

HHAeXchange Resources:

• HHAeXchange PA Home Health Information Center
• HHAeXchange Knowledge Base

EVV Questions/ Inquiries

If you have questions pertaining to EVV, send an email to Highmark Wholecare’s EVV team at EVV@highmark.com for assistance.

• Monitor Highmark Wholecare’s Monthly Provider Newsletters for additional information pertaining to EVV. To subscribe to the email notifications and monthly newsletters, sign up at the following link: e-Subscribe-for-Publications-and-Notifications.