Home Health Final Rule 2021

North Carolina Electronic Visit Verification

 Electronic Visit Verification has been mandated in the state of North Carolina with a 2021 start date for some agency types. When is the official start date?  What types of care and organizations does it apply to, and what are the requirements? Is NC an open model state in terms of the EVV system agencies have to implement? We will answer these questions and many more as we focus on NCDHHS EVV information. 

 

EVV for North Carolina Agencies

 

TO VIEW NCDHHS EVV COMPATIBLE SOFTWARE BY ALORA – CLICK HERE

 

NCDHHS Electronic Visit Verification Information

At its onset, EVV nationwide mandates were derived from the requirements of the 21st Century Cures Act. The Federal 21st Century Cures Act (2016) requires U.S states including North Carolina to implement a new electronic visit verification (EVV) system for agencies delivering certain types of care in the state. Electronic Visit Verification (EVV) software by definition is a system designed to electronically capture and verify provider visit information.

NC EVV REQUIREMENTS

What are the requirements for North Carolina agencies per the EVV mandate?

In concert with the 21st Century Cures Act, NC agency requirements for EVV visits note that any approved system must electronically capture:

  • The name of the patient who receives a service
  • The name of the caregiver who provides the service
  • The exact type of care/services that were provided
  • The exact location of the services provided
  • The exact date of services provided
  • The start and end time of the visit 

 

WHAT IS THE START DATE FOR NORTH CAROLINA EVV?

Section 12006 of the 21st Century Cures Act requires that the North Carolina Department of Health and Human Services (DHHS) begins using an Electronic Visit Verification (EVV) system for Personal Care Services (PCS) effective Jan. 1, 2021 and for Home Health Care Services (HHS) by January 2023.

  • Home Health Aide services are subject to EVV beginning Jan. 1, 2023
  • EVV is NOT required for adult care homes, licensed residential facilities, or supervisory and admission visits by nurses

EVV is defined as an approved system that uses electronic visit verification technology to record the time, date, location, and specific services that are provided during visits. These requirements are to ensure that people who should receive services, in fact, receive them as executed and reported.

AGENCIES ARE FREE TO CHOOSE A PREFERRED NORTH CAROLINA EVV SYSTEM

Agencies may elect to use the state selected Sandata system as outlined by NCDHHS, or an alternative NC EVV system so long as such system meets all EVV requirements set forth by the state. Sandata’s aggregator technology allows providers who use Alora (and select other systems) to continue to use their system of choice (systems will need to meet EVV & NCDHHS requirements). Sandata’s aggregator will work with any NC EVV system that meets the technical requirements. 

FINDING A NCDHHS COMPATIBLE EVV SYSTEM

ALORA IS A CERTIFIED NORTH CAROLINA EVV SYSTEM

NC Medicaid EVV Approved VendorAs agencies are free to choose any compliant EVV system for North Carolina, Alora Home Health Software for North Carolina offers an award-winning solution, consistently rated as the easiest to use by nurses and administrators alike. Alora is a compatible EVV system for NCDHHS EVV protocols. Caregivers can complete visits on their smartphones or tablets…while administrators can enjoy the power of managing the entire agency from the convenience of their mobile devices or desktop computers. Alora was engineered with the expertise of real home health professionals and software technology experts, resulting in an extraordinarily easy to use software system. With free training and an easy to use interface, agency adoption is seamless and quick.

 

NORTH CAROLINA HOMECARE BILLING & PAYROLL SOFTWARE

EVV data captured by Alora’s electronic visit verification software automatically flows into Alora’s main Home Health Software for North Carolina agencies. Once a caregiver departs from the patient’s home, visit information automatically updates within Alora, including the date of the visit with start and end times. The visit is then marked as complete, automating the process of preparation for billing and payroll. Any visits that are not executed as planned are immediately flagged within Alora Homecare software for manual review.

Visit the following link to learn more about Alora’s complete software for NC home health agencies.

Alora Home Care Software features an integrated EVV solution that offers compatibility with NCDHHS EVV requirements. Alora’s EVV for NCDHHS protocols is an enhanced EVV solution that is fully integrated into a powerful Home Health Software for North Carolina agencies.

REQUEST INFORMATION FOR NC EVV SYSTEM

 

NC EVV ADDITIONAL INFORMATION

Per the NCDHHS website:

In compliance with Section 12006 of the 21St Century Cures Act (the Cures Act), P.L. 114-255 was added to Section 1903(l) of the Social Security Act (SSA). Section 1903(l) requires the use of an EVV system for Personal Care Services (PCS) and Home Health Services (HHS) that require an in-home visit by a provider for states participating in the Medicaid program. Programs subject to the EVV requirement include State Plan Personal Care (PCS) [In-Home], Community Alternatives Program for Children (CAP/C), Community Alternatives Program for Adults (CAP/DA), self-directed personal attendant care services, Innovations Waiver, TBI Waiver and the 1115 Managed Care Demonstration Waiver. 

NC EVV Q&A

What waiver programs/services will begin EVV when Medicaid Managed Care launches on July 1, 2021?

Effective July 1, 2021, State Plan Personal Care Services (PCS)Medicaid-only beneficiaries will be managed by the Prepaid Health Plans (PHPs) and are subject to EVV through the PHPs.

Which NC Medicaid beneficiary services are required to participate in EVV?

EVV applies to Personal Care Services (PCS) [In-Home] provided under the state plan, or 1915(c) waivers and 1115 Managed Care Waiver. EVV is required for State Plan PCS, Community Alternatives Program for Children (CAP/C), Community Alternatives Program for Disabled Adults (CAP/DA), and self-directed personal attendant care services. These services and programs are subject to EVV beginning Jan.1, 2021. The Innovations and TBI waiver services as well as identified (b)(3) services will be subject to EVV by March 31, 2021.EVV will be required by the 1115 Managed Care Demonstration waiver (Standard Plans) at Managed Care go-live on July 1, 2021

What is considered a “Third-party” or “Alternate” EVV system?

The term “third-party EVV system” or “alternate EVV system” refers to the ability of a provider agency to use an EVV solution of their choosing that is not the State-supplied Sandata EVV system. These EVV applications can be used by the providers and will be responsible for delivering EVV data to NC Medicaid to comply with EVV requirements. Please note that providers choosing to use a third-party system may incur a cost from the vendor for that EVV system and the interface to NC Medicaid’s EVV system. A Global Positioning System (GPS) confirmation is required in North Carolina when using a third-party vendor.

If I use an alternate EVV vendor, how do I know it will work?

In concert with the requirements set forth in the 21st Century Cures Act, NC agencies may use any compliant EVV system that meets the following verification criteria:

  • The EVV system must identify the individual administering the service during the visit
  • The EVV system must identify the provider agency that employs or contracts with the individual providing the service.
  • The EVV system must identify the patient receiving the service during the visit
  • The EVV system must record the date of the visit
  • The EVV system must independently verify the official start and end time of the visit
  • The EVV system must record the location of the visit

 

Investigate and ask questions of any potential EVV vendor to ensure the system they offer is capable of meeting these requirements prior to implementation. The ability to work with the Sandata Aggregator should also be taken into consideration.

What waiver programs/services will begin Electronic Visit Verification when Medicaid Managed Care launches on July 1, 2021?

Effective July 1, 2021, State Plan Personal Care Services (PCS)Medicaid-onlybeneficiarieswill be managed by the Prepaid Health Plans (PHPs) and are subject to EVV through the PHPs.

Which North Carolina Medicaid beneficiary services are required to participate in EVV?

EVV applies to Personal Care Services (PCS) [In-Home] provided under the state plan, or 1915(c) waivers, and 1115 Managed Care Waiver. Electronic Visit Verification is required for State Plan PCS, Community Alternatives Program for Children (CAP/C), Community Alternatives Program for Disabled Adults (CAP/DA), and self-directed personal attendant care services. These services and programs are subject to EVV as of Jan.1, 2021. The Innovations and TBI waiver services as well as identified (b)(3) services will be subject to EVV by March 31, 2021.EVV will be required by the 1115 Managed Care Demonstration waiver (Standard Plans) at Managed Care go-live on July 1, 2021.

How can providers use the Sandata Aggregator system?

Aggregator training was sent to providers when the Alt EVV process was initiated. NCDHHS recommends completing the training to ensure agencies are prepared for Jan. 1, 2021. Software updates to the Sandata Aggregator occur once a month and downtimes are minimal. No user updates will be required.

Will Medicaid have a standard EVV consent form for all providers to use as part of the EVV implementation or will providers use their own form?

NC Medicaid will issue an EVV Attestation for all providers subject to EVV. Providers will attest that they have informed all of their beneficiaries who are subject to EVV of the requirement and maintain this attestation in their records.

For more information or a complete list of Q&A FAQs from the NCDHHS, click here to visit their website page

 

MassHealth EVV Requirements

 

 

 

 

 

THE ALORA HOME HEALTH BLOG

Read the Alora blog and website to learn more about home health software for North Carolina, NCDHHS compatible EVV, and recent news, articles, and commentaries, as well as other issues that pertain to North Carolina Home healthcare in the state and beyond. For more information on our blog, or for questions or feedback, please send us an email to HomeHealthSoftware@AloraHealth.com

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