Action Required for 1915(c) Waiver Providers: 1915(c) HCBS waiver providers (excluding MIIW) should take action to preserve EVV data. DMS is in the proces of transitioning the current state-sponsored system for 1915(c) HCBS waivers (known as EVV PCS) from Netsmart to Therap.
Go-live for the Therap system for EVV PCS is Jan. 1, 2025. Providers, including thoses using Netsmart as a third-party, must download historic EVV data from Netsmart before April 1, 2025. See the
EVV archiving message for details.
DMS will discuss archiving requirements during the EVV PCS Policy Webinar on Dec. 5, 2024 at 11 a.m. Eastern. Please see the
EVV PCS Policy Webinar announcement for registration information.
What Is Electronic Visit Verification?
Electronic visit verification (EVV) is an electronic system providers use to record information when delivering Personal Care Services (PCS), which includes certain in-home or community-based 1915(c) Home and Community Based Services (HCBS) or Home Health Care Services (HHCS). The use of EVV is a requirement of the
Cures Act passed by Congress in 2016.
EVV must electronically verify six aspects of service delivery: the date, location and type of service, the individual providing the service, the individual receiving the service and the start and end times of the service.
EVV offers several benefits such as eliminating the need for paper documentation, creating flexibility in scheduling and delivering services, improved monitoring of participant health, safety and welfare and reduction in potential Medicaid fraud, waste and abuse.
Guiding Principles of EVV
DMS believes EVV should:
- Simplify required documentation and reduce the administrative burden on Medicaid participants and providers.
- Improve Medicaid participant health, safety and welfare.
- Not reduce a Medicaid participant's services or alter chosen service delivery method.
- Be developed with input from all stakeholders.
- Include training for affected stakeholders.
- Bring Kentucky into compliance with federal law.
EVV for HHCS
DMS implemented EVV for HHCS in Kentucky on Jan. 1, 2024.
Effective Jan. 1, 2025,
any HHCS claim without a corresponding visit documented using EVV will be denied. The following provider types and service codes are required to use EVV when delivering in-home HHCS to Medicaid participants.
Provider Types
Services
- 410 - Respiratory Therapist - MIIW
- 552 - Registered Nurse - MIIW
- 559 - Licensed Practical Nurse - MIIW
- 420 - Physical Therapy - Home Health
- 430 - Occupational Therapy - Home Health
- 440 - Speech Therapy - Home Health
- 550 - Skilled Nursing - Home Health
- 560 - Medical Social Services - Home Health
- 570 - Home Health Aide - Home Health
- T1000 - Private Duty / Independent Nursing - Private Duty Nursing
Providers of HHCS have two options for EVV. DMS offers a state-sponsored system, which is free of charge for providers.
Therap provides the
state-sponsored system for EVV HHCS.
Providers can use a third-party EVV system or continue to use using an existing one. Providers are responsible for the costs of any third-party system they use and for ensuring the system meets the requirements of the
Cures Act.
EVV PCS for 1915(c) HCBS Waivers
Traditional service provider agencies and financial management agencies (FMA) that bill certain
in-home or community-based services must have direct service providers or participant-directed services employees enter visit information via EVV. This applies to five of Kentucky's six 1915(c) HCBS waivers:
Acquired Brain Injury and Acquired Brain Injury Long Term Care,
Home- and Community-Based,
Michelle P. Waiver and
Supports for Community Living. Read the
Electronic Visit Verification - Affected Services document for a listing of services by waiver that must use EVV.
In 2024, Kentucky is transitioning the state-sponsored EVV system for 1915(c) HCBS waivers from Netstmart's Mobile Caregiver+ system to Therap.
Go-live for the Therap system is January 1, 2025. Providers who transition to Therap can use the system free of charge. Providers also have the option to keep Netsmart as a third-party system, continue using an existing third-party system, or to begin using a third-party system. Providers are responsible for all costs associated with use of third-party systems, ensuring their preferred systems meet the requirements of the
Cures Act and ensuring full integration with Therap to allow DMS to reimburse for rendered services and conduct waiver quality assurance activities.
EVV Support
EVV Policy Questions
If you have policy questions about EVV, please email the 1915(c) Waiver Help Desk or call (844) 784-5614.
EVV PCS System Support
If you have technical issues with Mobile Caregiver+, submit a ticket using the
Netsmart Customer Support Portal or call Netsmart at (833) 483-5587.
EVV HHCS System Support
If you have questions about Therap EVV, please
email Therap.