Provider Notice issued 06/07/2024

Effective December 31, 2023, Illinois implemented the Electronic Visit Verification (EVV) system for several populations, including:

· Home Health Care Service (HHCS) providers, including those billing Illinois State Plan Medicaid, HealthChoice Illinois (HCI) Managed Care Organizations (MCOs), Medicare-Medicaid Alignment Initiative (MMAI) MCOs;
· Division of Specialized Care for Children (DSCC) providers; and
·Department of Human Services - Division of Developmental Disabilities (DHS DDD) providers.

To begin the process of working with the Illinois Statewide EVV Vendor, HHAeXchange (HHA), to record the EVV data elements defined in and required by the 21st Century Cures Act.pdf ("Cures Act”), organizations billing any of these entities for services were asked to complete the Provider Enrollment form on the HHAeXchange Illinois Information Center webpage. These six data elements include: the customer receiving the service, the provider delivering the service, the type of service, the location of the service delivery, the date of the service, and the time the service begins and ends. Trainings offered to these organizations throughout the HHA onboarding were recorded and are available on the HHAeXchange Illinois Information Center page.

Updates Related To EVV:

Dedicated Provider Help Line at HHAeXchange:

Effective June 3, 2024, providers can call 833-961-7429 to reach the dedicated Illinois provider help line at HHAeXchange. 

Medicare-Medicaid Alignment Initiative (MMAI):

Illinois has several Managed Care programs including HealthChoice Illinois (HCI), which covers Medicaid eligible customers, and MMAI, which covers individuals eligible for both Medicaid and Medicare. Illinois is requiring EVV for both HCI and MMAI MCOs. Refer to the Managed Care Programs webpage.

Illinois Department on Aging (IDoA) Implementation:

IDoA has EVV standards for In-Home Service (INH) provider agencies, which have been active since 2013 and can be found at evv-standards.pdf (illinois.gov). The IDoA go-live date for INH agencies wanting to switch to using HHA as their primary vendor for collecting EVV data and for all INH agencies needing to send their EVV data to HHA for state-wide aggregation was originally scheduled for June 3, 2024. However, this has been delayed to November 1, 2024, to address additional aspects of the go-live implementation.

IDoA provider agencies have not received credentials for logging into the EVV Statewide Aggregator (i.e., HHA) or log in information to the Learning Management System (LMS) for guidance and resources relative to HHA and EVV. Provider agencies that have completed their HHA enrollment form will receive these credentials closer to the go-live date.

IDoA providers using third-party systems to record EVV data can continue to work with HHA in completing the test and tasks needed to ensure Electronic Data Integration (EDI) between the primary EVV vendor and HHA, as the statewide EVV aggregator.

Illinois Department of Human Services, Division of Rehabilitation Services (DHS DRS) Implementation:

DHS DRS currently has EVV requirements for Individual Providers (Personal Assistants, non-agency certified nursing assistants (CNAs), non-agency licensed practical nurses (LPNs), and non-agency registered nurses (RNs)), Homemaker agencies, and Home Health agencies.

The Department of Healthcare and Family Services (HFS) plans to integrate the EVV data from DHS DRS providers to HHA beginning November 1, 2024, after completing a formal discovery process among DHS DRS, HHA, and HFS. More information about HHA and EVV can be found on the Illinois EVV webpage. 

Illinois Providers Using WellSky for Third-Party Electronic Data Interchange (EDI):

The State expects Home Health Care Service (HHCS) providers contracted with WellSky to begin transmitting data to HHA no later than July 1, 2024. If WellSky is unable to transmit data to HHA for HHCS providers by July 1, 2024, providers using WellSky will be required by the State to begin using the free HHA solution instead, to be in compliance with the Cures Act.

Upcoming “Townhall” Meetings:

HFS will begin hosting bi-weekly townhall meetings in June for providers, vendors, and state agency staff responsible for overseeing EVV compliance. The purpose of these meetings is to provide technical assistance, address common concerns, and relay state policy updates.

These meetings will occur on the 1^st Wednesday of the month from 9:00 a.m. to 10:30 a.m., and the 3^rd Tuesday of the month from 11:30 a.m. to 1:00 p.m. The first meeting is scheduled to occur on Tuesday, June 18, 2024, from 11:30 a.m. to 1:00 p.m.

A provider notice will be released prior to the first meeting on June 18, 2024. The notice will include a registration link applicable to all meetings and will solicit provider/vendor concerns and questions to be addressed in the meetings. HFS and HHA will develop each townhall meeting agenda based on feedback received during registration, as well as common concerns/inquiries fielded via HFS.EVV@illinois.gov. 

HHAeXchange Electronic Data Interchange (EDI) Tip Sheet:

HHA developed a tip sheet to assist providers using third-party EVV vendors responsible for transmitting EVV data to HHA for state-wide aggregation.

EVV Rejections Occurring for Current Home Health Care Visits:

In the Provider Notice issued 05/22/2024 (illinois.gov), HHCS providers were informed of visit rejections for customers enrolled with an MCO. These rejections are occurring due to incomplete authorization data between the MCOs and HHA. HFS anticipates this data to be fully available within the HHA system within the next two months.

For questions regarding this notice, please email HFS.EVV@illinois.gov.

Kelly Cunningham, Administrator 
Division of Medical Programs