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Illinois’ Electronic Visit Verification (EVV)
Electronic visit verification (EVV) is a technology-based system that efficiently verifies home healthcare visits. It collects information by capturing time, location, and attendance of home care workers.
A federally mandated requirement, EVV reduces the likelihood of error while promoting program integrity through a practical and simple monitoring system. It is designed to promote quality services and positive outcomes for our customers.
Why Illinois is implementing EVV:
In 2016, Congress passed the 21st Century Cures Act, which requires states to implement the use of Electronic Visit Verification (EVV) in all Medicaid-funded personal care services and home health care. The Federal Centers for Medicare and Medicaid (CMS) EVV webpage may be accessed here.
The purpose of implementing EVV is to support Illinois' goal to improve Medicaid program integrity, safeguard against fraud and abuse, improve program oversight, and comply with federal requirements.
What services are impacted under EVV:
Personal Care Services (PCS): Individuals receiving personal support in the home through Illinois' Home and Community Based Services (HCBS) waivers, This consists of services supporting Activities of Daily Living (ADLs), such as bathing, dressing, grooming, and meal preparation. Illinois’ (HCBS) waivers that fall under the PCS definition include:
- Persons with Disabilities waiver
- Brain Injury waiver
- HIV/AIDS waiver
- Elderly Waiver
- Adults with Developmental Disabilities Waiver
- Children and Young Adults with Developmental Disabilities Support Waiver
- Home Health Care Services (HHCS): Individuals receiving home health services through the Medicaid State Plan, or authorized under a waiver, including the Medically Fragile Technology Dependent (MFTD) Waiver
What HHCS services do not require EVV:
- Hospice services
- Durable Medical Equipment (DME)
- 05/10/2023: Informational Notice – Exemption from Electronic Visit Verification for Live-In Caregivers for Department of Human Services-Division of Developmental Disabilities (DDD) Waiver Programs. Guidance will be forthcoming for DDD caregivers on how to apply for the exemption to be granted. Stakeholders interested in DDD’s EVV exemption process are encouraged to sign up for DDD’s listserv communication here.
What EVV must capture:
- Type of service performed
- Individual receiving the service
- Date of the service
- Location of service delivery
- Individual providing the service
- Time the service begins and ends
The status of Illinois' EVV implementation efforts:
The 21st Century Cures Act includes a provision that allows states to delay implementation of EVV for up to one year if the state has encountered unavoidable delays and they can demonstrate they have made a good faith effort to comply with EVV requirements.
The Act mandates a compliance date of January 1, 2020, for all personal care services, and January 1, 2023, for all home health services. HFS is requesting a one-year extension of the implementation date for home health services. The Department estimates implementation for all personal care services and home health services in 2023.
HFS will continue to work with stakeholders, sister state agencies, managed care organizations, providers, and customers to implement a practical and efficient EVV system. The Department is committed to working with customers, providers, and vendors to meet training needs and implement a quality solution as quickly as possible. We will be conducting stakeholder meetings, sending notices, and using other tools to explain the process and solicit input.
Implementation Timeline:
January 1, 2020 — Original deadline for all personal care services to begin using EVV.
January 2021 — Begin to receive added stakeholder input, Request for Proposal (RFP) drafted.
June 2, 2021 — The Request for Proposal (RFP) for EVV posted.
March 2022 — HHAeXchange selected as Illinois EVV vendor.
January 1, 2023 — Original deadline for all home health services to begin using EVV. HFS requested a one-year Good Faith Extension and received Federal CMS approval on February 10, 2023.
September 1, 2023—Implementation date for EVV requirements for personal care services under the Adult with Developmental Disabilities waiver and the Children and Young Adults with Developmental Disabilities waivers only.
December 31, 2023 — Implementation date for EVV requirements for home health services for providers serving Medicaid customers. In addition to nursing, this includes Physical Therapy, Occupational Therapy, and Speech Therapy services provided in the individual’s home. For a full list of services in scope, please visit the “Services in Scope” section of HHAeXchange’s Illinois Information page at https://www.hhaexchange.com/info-hub/illinois.
Mid-2024—Implementation date for integrating PCS and HHCS EVV data from Illinois Department of Human Services’ Division of Rehabilitation Services (DRS) and Illinois Department on Aging (IDoA) providers to the HHAeXchange system
Questions and comments may be emailed to HFS.EVV@ILLINOIS.gov. Additional information pertaining to EVV implementation will continue to be posted on this website.
About Illinois’ EVV Vendor
In March of 2022, HHAeXchange was selected as the State’s EVV vendor and aggregator. Illinois is a hybrid state where agencies can use any qualified EVV vendor, but EVV information must still be submitted to HHAeXchange. To use an EVV system other than HHAeXchange, an agency must ensure compatibility with the Electronic Data Interchange (EDI) process. To learn more about HHAeXchange in Illinois, including the EDI process, please visit HHAeXchange’s Illinois webpage.