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Home and Community Based Services Manual

1.25 Electronic Visit Verification

Home and Community Based Services Manual


1.25 Electronic Visit Verification

The 21st Century Cures Act mandates the use of Electronic Visit Verification (EVV) for all Medicaid personal care services (PCS). This applies to PCS provided under sections 1905(a) (24), 1915(c), 1915(j), 1915(k), and Section 1115.

Missouri Code of State Regulations (CSR) 13 70-3.320 sets forth additional requirements for use of EVV for services identified by MO HealthNet Division and provided to a MO HealthNet participant with a prior authorization or care plan as approved by the Department of Health and Senior Services.

Purpose

EVV improves the quality of care provided to individuals and enhances quality control by utilizing technology to capture point-of-service information related to the delivery of in-home services.

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Requirement

Home and Community Based Services Manual


1.25 Electronic Visit Verification

Neither the 21st Century Cures Act nor MO CSR 13 70-3.320 provides HCBS participants the opportunity to opt out of these requirements. Refusal to comply with EVV requirements will result in closure of authorized HCBS through DSDS. DSDS shall initiate the Adverse Action process when a participant refuses to comply with EVV requirements. Participants not utilizing EVV, but who wish to comply with EVV requirements, shall be directed to contact their HCBS provider to ensure compliance. If a participant’s provider cannot accommodate the participant’s EVV needs, a provider change shall be initiated.

Providers and/or participants identified as noncompliant with EVV requirements by Missouri Medicaid Audit and Compliance (MMAC) will be forwarded to DSDS for a provider change or closure of HCBS.

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