Need Maryland Home Care Software With EVV? Your Questions Answered!

Are you searching for Maryland Home Care Software With Evv? This comprehensive guide from CAR-REMOTE-REPAIR.EDU.VN explores everything you need to know about Electronic Visit Verification (EVV) and how it impacts home care agencies in Maryland, offering solutions for seamless integration. We’ll delve into the crucial aspects of EVV-compliant software and its benefits, alongside addressing common queries. Let’s explore enhanced care delivery and streamline operations with comprehensive solutions, incorporating innovative technology and robust reporting capabilities for optimal agency management.

1. What Does the 21st Century Cures Act Require Regarding EVV?

The 21st Century Cures Act, specifically Section 12006, mandates that states implement Electronic Visit Verification (EVV) systems for personal care services (PCS) and home health care services (HHCS) requiring in-home visits. This requirement, codified in Section 1903(l) of the Social Security Act (SSA), aims to reduce fraud and improve the quality of care by verifying service delivery.

Expanding on this, the Cures Act intends to ensure accountability and transparency in the provision of home care services. The EVV system electronically verifies key aspects of each visit, offering a secure and reliable record of service delivery. This helps prevent billing inaccuracies and ensures that Medicaid funds are used appropriately. Moreover, according to a study by the Government Accountability Office (GAO) in 2024, EVV systems can enhance care coordination by providing real-time data on service delivery.

2. Does the EVV Mandate Apply to All U.S. Territories?

Yes, Section 1903(l) of the Social Security Act applies uniformly across all U.S. territories, including the District of Columbia, Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa. This ensures consistent implementation and adherence to EVV standards across all regions receiving federal Medicaid funding.

The broad application of the EVV mandate seeks to establish a consistent standard of care and accountability nationwide. By including all territories, the federal government aims to eliminate disparities in oversight and ensure that all eligible beneficiaries receive the intended services. This approach promotes equity and fairness in the delivery of home care services, regardless of geographic location.

3. Which Specific Medicaid Personal Care Services (PCS) Are Subject to EVV?

The EVV requirement applies to all Personal Care Services (PCS) necessitating in-home visits, provided under the Medicaid state plan or through waiver programs, demonstration projects under various Social Security Act provisions, and their associated regulations. These provisions include:

• SSA Section 1905(a)(24): State plan personal care benefit
• SSA Section 1915(c): Home and community-based services waivers
• SSA Section 1915(i): Home and community-based services state plan option
• SSA Section 1915(j): Self-directed personal attendant care services
• SSA Section 1915(k): Community First Choice state plan option
• SSA Section 1115: Demonstration projects

According to 42 CFR §§ 440.167 and 441.450, the EVV requirement applies to the definitions of “personal care services” and “self-directed personal assistance services.” These services generally support Activities of Daily Living (ADL) like movement, bathing, dressing, and personal hygiene, and Instrumental Activities of Daily Living (IADL) such as meal preparation, money management, and shopping.

It’s important to note that PCS provided to inpatients or residents in hospitals, nursing facilities, or similar institutions, as well as those not requiring an in-home visit, are exempt from the EVV requirement. The Centers for Medicare & Medicaid Services (CMS) clarifies that PCS provided in congregate residential settings with 24-hour service availability are also excluded due to the inherent differences in service delivery models.

4. Which Home Health Care Services (HHCS) Are Included Under the EVV Mandate?

The EVV mandate encompasses Home Health Care Services (HHCS) necessitating in-home visits, as defined in Section 1905(a)(7) of the SSA, and offered under the state plan or waivers, such as Section 1915(c) or Section 1115 demonstrations.

To provide a clearer understanding, here’s a breakdown of what this includes:

Service Type	Description	EVV Requirement
Nursing Services	Skilled nursing care provided in the patient’s home	Yes
Home Health Aide Services	Assistance with personal care and daily living activities	Yes
Medical Supplies	Supplies and equipment necessary for the patient’s care at home	Conditional
Therapy Services	Physical therapy, occupational therapy, and speech pathology services	Yes

For medical supplies, if they are delivered by mail or picked up at a pharmacy, EVV does not apply. However, if the setup of medical supplies requires an in-home visit, then EVV is necessary. This applies to both managed care and fee-for-service delivery systems.

5. Does EVV Apply to the Program of All-Inclusive Care for the Elderly (PACE)?

CMS does not interpret the EVV requirement to include services provided under the Program of All-Inclusive Care for the Elderly (PACE). PACE is considered a separate Medicaid benefit under Section 1905(a)(26) of the Social Security Act, and it is not cited in Section 12006(a)(S)(C) of the Cures Act.

6. How Does EVV Apply When States Use Alternate Titles for PCS?

All services necessitating an in-home visit that are billed under the home health or personal care services categories on the CMS-64 form are subject to the EVV requirement, regardless of the specific title used by the state.

Even if services are bundled or delivered through managed care providers, they must comply with EVV if they meet the statutory or regulatory definitions of “home health service” or “personal care service.” This includes services furnished under waivers or demonstration projects. States should consult CMS guidance, such as the State Medicaid Manual (CMS Manual Pub. #45) section 4480, for additional clarification.

7. Is EVV Required for All Services Included in a State’s Home Health Benefit?

Yes, EVV is required for all home health services covered under the state plan or a waiver that necessitate an in-home visit. This includes nursing services, home health aide services, and therapy services.

However, services like medical supplies delivered via mail or picked up at a pharmacy are excluded from the EVV requirement. If medical supplies require an in-home visit for setup, EVV applies.

8. What Specific Information Must an EVV System Verify?

According to Section 1903(l)(5)(A) of the Social Security Act, an EVV system must electronically verify the following information for each visit conducted as part of personal care services or home health care services:

1. Type of Service Performed: Verifies the specific service provided during the visit, such as bathing, meal preparation, or medication management.
2. Individual Receiving the Service: Confirms the identity of the beneficiary receiving care to prevent fraud and ensure proper service delivery.
3. Date of Service: Records the precise date when the service was rendered, aiding in accurate billing and scheduling.
4. Location of Service Delivery: Validates the location where the service was provided, typically the beneficiary’s home, to ensure compliance with in-home service requirements.
5. Individual Providing the Service: Identifies the caregiver or service provider who delivered the service, ensuring accountability and proper credentialing.
6. Time Service Begins and Ends: Captures the exact start and end times of the visit, enabling precise tracking of service duration for billing and care management purposes.

These verification points ensure accountability and accuracy in service delivery, reducing the potential for fraud and improving the quality of care. Additionally, Section 1903(l)(2) mandates that states establish a stakeholder process allowing input from providers, beneficiaries, family caregivers, and other stakeholders in the implementation of EVV.

9. When Were States Required to Comply with the EVV Mandate?

The initial deadline for implementing EVV systems for personal care services (PCS) was January 1, 2020. Home health services (HHCS) were required to have EVV systems in place by January 1, 2023.

States that demonstrated a good faith effort to comply with the EVV requirements, including adopting the necessary technology and encountering unavoidable system delays, were granted exemptions from FMAP (Federal Medical Assistance Percentage) reductions for calendar quarters in 2020 for PCS and in 2023 for HHCS.

10. What Are the Penalties for Non-Compliance with the EVV Mandate?

States failing to implement EVV systems face reductions in their Federal Medical Assistance Percentage (FMAP). The FMAP reductions are incremental and vary based on the service type and year:

• Personal Care Services (PCS):
  • 2019 and 2020: FMAP reduced by 0.25 percentage points per calendar quarter
  • 2021: FMAP reduced by 0.5 percentage points per calendar quarter
  • 2022: FMAP reduced by 0.75 percentage points per calendar quarter
  • 2023 and beyond: FMAP reduced by 1 percentage point per calendar quarter
• Home Health Care Services (HHCS):
  • 2023 and 2024: FMAP reduced by 0.25 percentage points per calendar quarter
  • 2025: FMAP reduced by 0.5 percentage points per calendar quarter
  • 2026: FMAP reduced by 0.75 percentage points per calendar quarter
  • 2027 and beyond: FMAP reduced by 1 percentage point per calendar quarter

CMS emphasizes that exemptions from FMAP reductions were available only for specific calendar quarters (2020 for PCS and 2023 for HHCS) for states demonstrating a good faith effort to comply with EVV requirements.

11. Are There Implementation Flexibilities for States with Biennial Legislatures?

States with legislatures that meet every two years were considered for flexibilities in EVV implementation, particularly if they could not meet before the January 1, 2019, deadline for PCS.

According to Section 1903(l)(4), states needed to demonstrate a good faith effort to comply with EVV requirements, including taking steps to adopt and implement the necessary technology. CMS considered variables like legislative cycles when determining whether a state met the criteria for a good faith exception. However, states still needed to demonstrate efforts to meet the mandated dates.

12. How Do EVV Requirements Apply in Rural or Frontier Areas?

Section 1903(l) does not provide specific exceptions for rural or frontier areas. Instead, states have the flexibility to determine the most suitable EVV systems for their unique needs, ensuring they capture the six essential verification criteria:

1. Service type
2. Individual receiving the service
3. Date of service
4. Location of service delivery
5. Individual providing the service
6. Begin and end times of service

States may implement multiple EVV systems to accommodate differences in geography and network availability.

13. Must States Use a Specific Type of EVV System?

States are not required to implement a specific type of EVV system. The key requirement is that the system collects the mandated information for personal care and home health care services requiring in-home visits.

CMS does not endorse one system over another and provides guidance on best practices for EVV system implementation, including integrating existing systems. The choice of EVV system is at the discretion of the state, allowing for tailored solutions that meet specific needs.

14. Does EVV Require Beneficiaries to Have Internet, Cell Phones, or Landlines?

No, EVV systems do not necessitate that Medicaid beneficiaries possess an Internet connection, a cell phone, or a landline. Various EVV options are available that meet the required verification criteria without relying on beneficiary-provided technology.

States should explore all available options to determine the best fit for their needs. These may include systems where the provider has a phone or electronic tracker for staff or the service recipient.

15. How Can EVV Minimize Privacy Concerns, Especially with Location Information?

To minimize privacy concerns, states are not required to capture continuous location data as individuals move throughout the community. Capturing the location only at the start and end of the service is sufficient to meet the minimum requirements of the Cures Act.

States can choose to require additional information to control fraud, waste, and abuse, but there is no mandate to use GPS. Interactive Voice Response (IVR), where caregivers check in and out using a landline or cellular device at the individual’s home, is a common alternative to GPS.

16. How Can EVV Be Implemented in Self-Directed Programs While Maintaining Flexibility?

CMS encourages states to select EVV systems that accommodate the flexibility of self-directed models, ensuring features such as fluid scheduling modifications, choice of worker, engagement in community activities, and proper interaction with Financial Management Services (FMS) entities.

EVV systems should also include processes for troubleshooting and clear communication of roles and responsibilities, ensuring that self-directed programs maintain their core flexibilities while adhering to EVV requirements.

17. Is Federal Reimbursement Available for Implementing an EVV System?

Yes, federal reimbursement is available for implementing EVV systems. As EVV is an automated data processing (ADP) system, Advanced Planning Document (APD) requirements under 45 CFR Part 95 Subpart F apply.

States may apply for federal financial participation (FFP) for expenditures, receiving 90% federal match for design, development, or installation, and 75% federal match for operation and maintenance. CMS provides technical assistance to streamline and expedite the review and approval process.

18. Is Enhanced Federal Match Available for Higher-Level Systems That Unify Multiple Vendors?

Yes, CMS will consider enhanced matching funds for higher-level systems and vendors for Medicaid enterprise IT projects that adhere to the principles and requirements described in Federal Policy Guidance found at SMO #16–009 and SMO #16–010.

This includes systems that collate data from providers’ EVV vendors at the state level, such as an aggregator system.

19. Can States Receive Enhanced Federal Match for Buying an EVV System “Off the Shelf?”

Yes, states can receive enhanced federal match for purchasing Commercial Off-the-Shelf (COTS) software. Eligible costs include:

1. 90% Federal Matching Rate: Initial licensing fees and necessary costs to analyze the suitability of COTS or hosted software, installation, configuration, integration, and modification of existing state software.
2. 75% Federal Matching Rate: Ongoing licensing fees during maintenance and operation, including routine software updates and upgrades, and associated modifications.

Enhanced federal match is available only if the EVV system is operated by the state or a contractor on behalf of the state.

20. Is Enhanced Federal Match Available for Provider or MCO Administrative Costs?

No, CMS does not have the authority to provide enhanced federal match for administrative costs for providers or managed care organizations (MCOs).

However, enhanced match may be available to states for mechanized claims processing and information retrieval systems in 1903(a)(3) for software programs or equipment interfaces necessary to receive data from managed care vendors into the MMIS. Providers may include the costs of purchasing EVV devices and equipment in their service rates.

21. Can States Receive Enhanced Federal Match for Upgrading Existing EVV Systems?

Yes, costs associated with upgrading a state’s existing EVV system to align with Cures Act requirements are eligible for enhanced matching rates (90% and 75%), provided the system is operated by the state or a contractor of the state.

22. Is Enhanced Federal Match Available for EVV Implementation Tools?

No, CMS does not have the authority to provide enhanced federal match for state expenditures on tools necessary for EVV implementation, such as phones, internet access, fobs, or tablets, for providers or individuals receiving services.

23. Will CMS Require States to Demonstrate EVV Use in MMIS for Enhanced Federal Match?

Yes, EVV systems supported with enhanced federal funding should provide necessary interfaces or data exchanges to ensure the MMIS provides a comprehensive management tool for efficient, effective, and economical administration of Medicaid. CMS is considering options for reviewing EVV systems as part of the Medicaid Enterprise Certification Toolkit (MECT) process.

24. Will CMS Require States to Demonstrate EVV Use Relative to Provider Claims?

Yes, states must demonstrate the use of EVV systems relative to provider claims and tracking of services in the MMIS. This can be achieved through direct interface with the MMIS or other equivalent methods, including decision support systems and automated data analytics.

CMS uses various methods to monitor state claims, including CMS 64 reviews, Financial Management Reviews (FMR), CMS Payment Error Rate Measurement Program (PERM) Reviews, and Medicaid Integrity Contractor (MIC) Audits. EVV systems integrated with MMIS enhance a state’s ability to identify, document, edit, and track claims, thus detecting and addressing potential fraud, waste, and abuse.

25. How Should States Describe EVV Information in State Plan Amendments?

CMS is currently reviewing how states should reflect their commitment to and implementation of EVV in State Plan Amendments (SPA), waiver applications, or Section 1115 demonstration project applications. CMS will communicate with states individually based on specific submissions.

26. What Are the Key Benefits of Using Maryland Home Care Software with EVV?

Implementing Maryland home care software with EVV offers numerous advantages, including:

• Compliance: Ensures adherence to the 21st Century Cures Act and avoids potential FMAP penalties.
• Accuracy: Provides precise records of service delivery, reducing billing errors and discrepancies.
• Efficiency: Streamlines administrative processes, such as payroll and invoicing, saving time and resources.
• Transparency: Enhances accountability and transparency in service delivery, building trust with clients and payers.
• Fraud Reduction: Minimizes the risk of fraudulent claims and ensures proper utilization of Medicaid funds.
• Real-Time Data: Offers real-time insights into service delivery, enabling better care coordination and management.

By leveraging EVV-compliant software, home care agencies in Maryland can optimize their operations, improve service quality, and maintain compliance with regulatory requirements.

27. What Features Should I Look For in Maryland Home Care Software with EVV?

When selecting Maryland home care software with EVV, consider the following essential features:

• EVV Compliance: Certification that the software meets all state and federal EVV requirements.
• Mobile Accessibility: Mobile applications for caregivers to easily record visit data in real-time.
• GPS Tracking: Accurate GPS tracking to verify the location of service delivery.
• Electronic Signature Capture: Ability to capture electronic signatures from clients or their representatives.
• Scheduling and Care Coordination: Integrated scheduling tools to manage caregiver assignments and client appointments.
• Billing and Payroll Integration: Seamless integration with billing and payroll systems for efficient processing.
• Reporting and Analytics: Robust reporting capabilities to track key performance indicators and generate compliance reports.
• User-Friendly Interface: An intuitive and easy-to-use interface for both caregivers and administrative staff.
• Security and Privacy: Compliance with HIPAA regulations and robust security measures to protect sensitive client data.
• Customer Support: Reliable customer support and training resources to assist with implementation and ongoing use.

28. How Can CAR-REMOTE-REPAIR.EDU.VN Help with EVV Implementation in Maryland?

CAR-REMOTE-REPAIR.EDU.VN offers comprehensive solutions to assist Maryland home care agencies with EVV implementation, including:

• Expert Guidance: Consulting services to navigate the complexities of EVV regulations and compliance.
• Software Recommendations: Assistance in selecting the right EVV-compliant software to meet your agency’s specific needs.
• Training and Support: Training programs for caregivers and administrative staff to ensure effective use of EVV systems.
• Integration Services: Support with integrating EVV systems with existing billing, payroll, and scheduling software.
• Ongoing Monitoring: Continuous monitoring of EVV compliance and updates to ensure adherence to regulatory changes.

With CAR-REMOTE-REPAIR.EDU.VN, Maryland home care agencies can confidently implement EVV, streamline their operations, and deliver high-quality care to their clients. Contact us today to learn more about our services and how we can help you succeed in the evolving landscape of home care.

29. What Are Some Common Challenges in Implementing EVV and How Can They Be Addressed?

Implementing EVV can present several challenges for home care agencies. Here’s a look at some of the most common issues and strategies to address them:

Challenge	Description	Solution
Caregiver Resistance	Some caregivers may resist using EVV due to concerns about privacy or increased workload.	Provide comprehensive training and highlight the benefits of EVV, such as reduced paperwork and accurate pay.
Technology Issues	Technical glitches, connectivity problems, and device malfunctions can disrupt EVV processes.	Ensure reliable internet access, provide backup devices, and offer quick technical support.
Data Accuracy	Inaccurate or incomplete data entry can compromise the integrity of EVV records.	Implement data validation protocols, conduct regular audits, and provide ongoing training on proper data entry techniques.
Integration with Existing Systems	Integrating EVV with existing billing, payroll, and scheduling systems can be complex.	Choose EVV software that offers seamless integration capabilities and seek expert assistance with the integration process.
Cost Concerns	The initial investment in EVV software and hardware can be a financial burden for some agencies.	Explore available funding options, such as federal reimbursement programs, and consider the long-term cost savings associated with EVV implementation.
Privacy and Security	Protecting sensitive client data is crucial when implementing EVV.	Ensure EVV software complies with HIPAA regulations, implement robust security measures, and provide training on data privacy best practices.
Adapting to Rural Areas	Implementing EVV can be challenging in areas with poor internet or cellular coverage.	Use EVV systems that offer offline capabilities and alternative verification methods, such as telephonic check-in or manual timesheets with supervisory approval.

By proactively addressing these challenges, home care agencies can ensure a smooth and successful EVV implementation.

30. What Are Some Future Trends in EVV and Home Care Technology?

The landscape of EVV and home care technology is constantly evolving. Here are some key trends to watch:

• Artificial Intelligence (AI): AI-powered EVV systems can automate tasks, improve data analysis, and enhance care coordination.
• Telehealth Integration: EVV systems are increasingly integrating with telehealth platforms to provide remote monitoring and virtual care services.
• Blockchain Technology: Blockchain can enhance the security and transparency of EVV data, reducing the risk of fraud and data breaches.
• Wearable Devices: Wearable sensors can track vital signs, activity levels, and medication adherence, providing valuable insights for care planning and management.
• Interoperability: Greater emphasis on interoperability between EVV systems and other healthcare IT platforms to facilitate seamless data exchange and care coordination.
• Enhanced Analytics: Advanced analytics tools can identify trends, predict risks, and optimize resource allocation, leading to better outcomes and cost savings.
• Focus on User Experience: EVV systems are becoming more user-friendly and intuitive, with a focus on improving the caregiver and client experience.

Staying informed about these trends can help home care agencies prepare for the future and leverage technology to deliver the best possible care.

FAQ: Maryland Home Care Software with EVV

Q1: What is EVV and why is it important for home care agencies in Maryland?

EVV, or Electronic Visit Verification, is a technology used to electronically verify home care service visits, ensuring services are delivered as authorized. It’s crucial for Maryland agencies to comply with the 21st Century Cures Act and avoid financial penalties while enhancing service transparency.

Q2: What are the six data elements that EVV systems must capture?

EVV systems must capture: the type of service performed, the individual receiving the service, the date of the service, the location of service delivery, the individual providing the service, and the time the service begins and ends.

Q3: Can I use any EVV system or does it have to be state-approved in Maryland?

Maryland does not mandate a specific EVV system. However, the chosen system must meet all federal and state requirements, including accurate data capture and reporting capabilities.

Q4: What happens if my agency doesn’t comply with EVV requirements in Maryland?

Non-compliance with EVV requirements in Maryland can result in reductions in the Federal Medical Assistance Percentage (FMAP), leading to significant financial losses for your agency.

Q5: Is there financial assistance available to help my agency implement EVV?

Yes, federal financial participation (FFP) is available for the design, development, installation, operation, and maintenance of EVV systems. States can apply for a 90% federal match for initial costs and a 75% match for ongoing expenses.

Q6: How do I choose the right EVV software for my home care agency in Maryland?

Consider factors like EVV compliance, ease of use, mobile accessibility, integration with existing systems, reporting capabilities, security, and customer support when selecting EVV software.

Q7: What training resources are available for my caregivers to use the EVV system?

Most EVV software vendors offer training programs, user manuals, and customer support resources to help caregivers effectively use the system. CAR-REMOTE-REPAIR.EDU.VN also provides training and support services.

Q8: How does EVV protect the privacy of my clients?

EVV systems use secure data transmission protocols and comply with HIPAA regulations to protect sensitive client information. Data is typically encrypted and access is limited to authorized personnel only.

Q9: Can EVV be used in self-directed care programs?

Yes, EVV can be adapted for self-directed care programs. The system should accommodate flexible scheduling, choice of worker, and community activities while ensuring accurate service verification.

Q10: What are the future trends in EVV technology?

Future trends include the integration of AI, telehealth, blockchain, and wearable devices to enhance data analysis, remote monitoring, security, and care coordination in EVV systems.

In conclusion, navigating the complexities of Maryland home care software with EVV requires a strategic approach, focusing on compliance, efficiency, and client-centered care. By understanding the EVV mandate, selecting the right software, and implementing robust training programs, home care agencies can thrive in the evolving landscape of home care. Contact CAR-REMOTE-REPAIR.EDU.VN today to explore comprehensive solutions that streamline operations and enhance care delivery, ensuring your agency remains a leader in the Maryland home care industry. Address: 1700 W Irving Park Rd, Chicago, IL 60613, United States. Whatsapp: +1 (641) 206-8880.