Medicaid Concepts: Electronic Visit Verification

This is part of our Medicaid Concepts series, in which we provide a high level overview of key concepts in the Medicaid industry today.

What do we mean by electronic visit verification (EVV)?

Electronic visit verification (EVV) is a category of technologies and services used to validate that a visit actually occurred (usually in the member’s home). While EVV has been around for a long time, the 21st Century Cures Act made it mandatory for all state Medicaid programs by January 2020 for personal care services and January 2023 for home health services.

At a minimum, EVV systems must document:

  • Date of service
  • Location of service
  • Individual providing service
  • Type of service
  • Individual receiving service
  • Time the service begins and ends

What role does Medicaid play?

In addition to implementing required EVV systems, Medicaid agencies are in a unique position to leverage EVV data to improve member service provision. Medicaid agencies also play an important role in educating members on the benefits of EVV and reassuring those members that have privacy concerns related to GPS data tied to their home.

While EVV is primarily designed to prevent fraud in the Medicaid system, there are opportunities to use EVV data to improve care coordination and identify member quality gaps. The ability to use EVV to improve member outcomes is only beginning to be explored.

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