22-725 Self-Register by October 19, 2022 to Access the State-Sponsored EVV System

Date: 09/14/22

This information applies to Participating Physician Groups (PPGs), Ancillary providers, and Community Supports (CS) Providers.

Plan early to register and train on how to use the new electronic visit verification system and aggregator

Electronic Visit Verification (EVV) tracks in-home service visits through a federally mandated telephone and computer-based application program. The program was developed to help reduce fraud, waste and abuse.

This new requirement starts January 1, 2023, and is at the direction of the Department of Health Care Services (DHCS).¹

Provider types required to use EVV

Medi-Cal providers who give any of the below listed services in a member’s home must use EVV. This includes visits that begin in the community and end with in-home care or vice versa.

•  Home health care services (HHCS).
•  Personal care services (PCS) and homemaker services.
•  Day habilitation programs services.
•  Respite services.
•  Community-Based Adult Services-Emergency Remote Services (CBAS-ERS) programs.

Services excluded from EVV requirements

The following services are not subject to EVV requirements:

• HHCS or PCS that do not require an in-home visit.
• HHCS or PCS provided in congregate residential settings where 24-hour service is available.
• HHCS or PCS rendered by an individual living in the member’s residence does not constitute an “in-home visit.”
• Any services rendered through the Program of All-Inclusive Care for the Elderly.
• HHCS or PCS that are provided to inpatients or residents of a hospital, nursing facility including skilled nursing facility or residence of nursing facility, intermediate care facility for individuals with intellectual disabilities, or an institution for mental diseases.
• Durable medical equipment (DME).

Where to self-register by October 19

Visit the DHCS website. This link offers information about:

• Self-registration with a quick reference guide that details how to fill out the registration form.
• A link to provider types and codes.
• Resources and CalEVV training videos which has everything you need to know about using the CalEVV program.

Information required by providers

The EVV program will require providers to capture and transmit the following six mandatory data components for each in-home visit:

• 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.

Support required by the health plan

The Plan will monitor providers to ensure compliance with these requirements with the following established guidelines:

• Monitor providers for compliance with EVV requirements, and alert DHCS of any compliance issues.
• Supply providers with technical assistance and training on EVV compliance.
• Require providers to comply with an approved corrective action plan (CAP).
• Deny payment if the provider is not complying with EVV requirements.
• Arrange for members to receive services from a provider that complies with EVV requirements.

Additional information

If you have questions regarding the information contained in this update, contact CalViva Health at 888-893-1569.

¹ See DHCS All Plan Letter 22-014, dated July 21, 2022.