As of November 1, 2022, providers contracted to deliver non-skilled in-home services (i.e., attendant care, personal care, homemaker, habilitation, respite) and in-home skilled nursing services ( i.e., home health) must be compliant with Electronic Visit Verification (EVV) in order to receive Medicaid reimbursement for services.
Over the past two years, AHCCCS, its vendor partner Sandata, its contracted managed care organizations (MCOs), and the Centers for Medicare and Medicaid Services (CMS) have been preparing to enforce EVV compliance by monitoring provider readiness milestones, conducting outreach, and providing technical assistance to the provider community.
Until November 1, providers can still receive reimbursement for services even if there is no EVV visit to match to a claim or the EVV visit data is incomplete. Providers should use this period to incorporate EVV into day-to-day business practices, including developing operational procedures, training administrative personnel, onboarding members and caregivers, and logging visits. More importantly this is an opportunity for providers to self-monitor agency compliance in order to avoid billing challenges when the hard claim edit period begins on November 1, 2022. Once the hard claim edits begin, providers will not get paid unless all the required EVV visit data is present.
More information about the EVV claims deadline, and training and technical assistance, is posted on the AHCCCS EVV web page.
