Georgia Medicaid Electronic Visit Verification

Electronic Visit Verification (EVV)

WHAT IS ELECTRONIC VISIT VERIFICATION (EVV)?
Electronic Visit Verification (EVV) is a technology that automates the gathering of service information by capturing time, attendance and care plan information entered by a home care worker at the point of care. EVV gives providers, care coordinators, and DCH access to service delivery information in real time to ensure there are no gaps in care throughout the entire course of the service plan. The technology helps to reduce the occurrence of fraud in home care delivery by removing the elements most closely associated with improper record keeping including paper time sheets and manual billing.
At a minimum, EVV electronically verifies the:
 
  • Type of service performed;
  • Individual receiving the service;
  • Individual providing the service;
  • Date the service was provided;
  • Location of service delivery; and
  • Time the service begins and ends.
WHY IS GEORGIA IMPLEMENTING EVV?
The 21st Century Cures Act and Electronic Visit Verification (EVV)
 
In December 2016, the 114th US Congress enacted the 21st Century Cures Act. Section 12006 of the Act requires states to implement Electronic Visit Verification (EVV) for Medicaid-financed personal care services and home health care services by January 1, 2019 and January 1, 2023, respectively.
 
The 21st Century Cures Act requires states to implement EVV to avoid an escalating reduction in their federal Medicaid funding, which could have a negative impact on the provider community. Under the Act and with CMS approval, EVV systems operated by the state or a contractor on behalf of the State qualifies for enhanced Federal Medical Assistance Percentage (FMAP) matching funds (90% for implementation, 75% for ongoing costs).
 
Georgia is committed to adhering to the federal 21st Century Cures Act mandate. It contributes to Georgia Medicaid’s mission of providing access to affordable, quality health care services for Medicaid members. EVV will help to reduce billing errors and improve claims payment accuracy as well as reduce Medicaid fraud, waste and abuse by verifying services were rendered.
WHAT WILL EVV IMPLEMENTATION LOOK LIKE FOR GEORGIA?
The Department of Community Health (DCH) will provide an EVV system to Georgia providers by contracting with a certified EVV solutions vendor to deliver Georgia’s EVV system. Our state-wide EVV vendor will work to provide system orientation and training to providers as well as guidance and assistance with successful implementation. There is no direct cost to the members or providers who use Georgia’s provided EVV system. DCH encourages all providers to use Georgia’s EVV system but it is open to agency providers using their own EVV systems that interface with DCH.
 
Providers should check back on the EVV website and GAMMIS for updates regarding EVV. Please make sure provider email addresses and phone numbers in GAMMIS are current to ensure you have the ability to access the forthcoming EVV system, as well as receive future communications related to EVV.
 
The EVV Vendor Customer Care Number and additional contact information will be provided once DCH selects the state-wide EVV system supplier. In the meantime, please email evv.medicaid@dch.ga.gov if you have additional questions.
CAN PROVIDERS CONTINUE TO USE THEIR CURRENT OR OTHER EVV SYSTEMS?
Other EVV systems are allowable as long as they meet DCH’s system interface requirements. The systems must interface/aggregate with Georgia’s EVV system. They must collect visit data, have GPS functionality, and send visit information to Georgia’s EVV system in near-real time.
WHAT SERVICES ARE INCLUDED IN THE EVV IMPLEMENTATION?
At this time, only services provided through the fee-for-service (FFS) Medicaid program will be included in the EVV implementation. Services reimbursed through a Care Management Organization (CMO) are not part of the Georgia EVV program. DCH may phase CMOs into the EVV system at a later date and will provide information regarding their integration.
WHO WILL BE IMPACTED BY THE EVV IMPLEMENTATION?
There are several Medicaid programs that are impacted by the EVV implementation. Medicaid providers servicing the programs below will need immediate information about how EVV will affect them and should check this page often to find valuable information.
WHERE CAN MORE INFORMATION BE FOUND ABOUT GEORGIA’S EVV IMPLEMENTATION?
Check out the links on the left side of this page for more information. There you’ll find more specific details about our EVV implementation along with some printable material to share within the Medicaid community.
 
Also, to receive more news and alerts about our efforts towards a successful EVV implementation here in Georgia, you can:

Email us at evv.medicaid@dch.ga.gov if you have more questions regarding Georgia’s EVV implementation.