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The 21st Century Cures Act is a federal mandate which states that effective January 1, 2021, agencies providing personal care services (PCS) and home health services (HHCS) must have an Electronic Visit Verification (EVV) solution in place.
If they do not adhere, they are at risk of having their Medicaid claims denied. But what is EVV and why is it so important for ABA practitioners, parents and patients?
Continue reading this article to find out more useful information.
What is Electronic Visit Verification (EVV)?
Electronic Visit Verification, or EVV, is a new method used to verify home healthcare visits.
The purpose behind wanting more visibility is to ensure that visits are actually taking place and that patients are truly getting the care they need. Also, that Medicaid is being billed properly.
EVV helps cut down on home visit fraud by practitioners, and ensures that individual patient care is not overlooked.
How Does EVV Work?
EVV is a technology that allows professionals to track the following data:
- Time service begins and ends
- Date of service
- Location of service
- Name of individual receiving service
- Name of individual providing service
- Type of service and billing code
It’s important to note that while location will be recorded at the time of clock in and clock out, it will not be tracked throughout the actual shift.
Most EVV systems use GPS technology to pinpoint when a caregiver arrives at and leaves a location, while others utilize telephone lines.
In these cases, caregivers must call the agency office from a landline that can be traced back.
Benefits of Electronic Visit Verification
While having a basic EVV solution will help meet state legal requirements, there are more benefits for agencies, businesses and behavior analysis services providers.
Time will be saved as processes will be automated and client care will improve.
The 21st Century Cures Act
As stated in the introduction, The 21st Century Cures Act is a federal mandate directing EVV implementation and oversight.
Although the act sets key data points that must be collected and verified, each state will be responsible for creating and enforcing their own systems.
State governments will decide how to gather and report data used by EVV vendors, and whether or not to create additional compliance rules.
The Impact of Medicaid Fraud
Medicaid fraud has been rising sharply over the past few years.
According to The Wall Street Journal, the U.S. government recovered $3.3 billion federal health program fraud tied to individuals and companies in fiscal 2014.
That’s why effective EVV implementation is so important in preventing fraud, but also providing more accurate reimbursement for those who are following the rules.
Rethink Behavioral Health & EVV
Rethink’s practice management suite currently offers Electronic Visit Verification (EVV). This technology gives us the ability to accurately capture visit start and end times, their corresponding GPS location and seamlessly send these visits to the state Medicaid office via the Authorized EVV Aggregator.
Our goal is to help inform, educate, and train behavior analysis service providers as we move forward together with EVV and state mandatory compliance.
If you have any questions on anything in this article or specifically regarding your business or individual state requirements, don’t hesitate to reach out to us.