HSP Policy: EVV for Homemaker/Homehealth agencies

Note:

• HHAX free version (EVV system for agencies) is not available to agencies at this time.
• Until the HHAX free version is made available for agencies to use, Homemaker/Homehealth agencies must use their preferred EVV Vendor for EVV compliance.

• When the HHAX free version becomes available, we'll post it here. Agencies are encouraged to check this website again.

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Communication: 02/18/2025 (pdf)

HSP Policy	Electronic Visit Verification (EVV) for Homemaker, Home Health Agencies
State and Federal Statutory Authority	42 USC 1396b(l)) 305 ILCS 5/5-5f(g)
Illinois Administrative Code Reference	89 Illinois Administrative Code 686.1630
Other References	IDHS/HSP Website
Effective Date	February 18, 2025

1. Overview

1. 42 USC §1396b(l) requires all state Medicaid programs to implement an Electronic Visit Verification (EVV) system for personal care services (PCS) and home health care services (HHCS).
2. All providers employed by Homemaker and Home Health agencies must use an EVV system to track and document the time spent by the provider providing the services authorized in the customer's Home Services Program (HSP) Service Plan.
3. The EVV system must have the ability to capture all six (6) elements required under the Federal 21st Century Cure's Act. EVV must capture:
   1. The type of service performed.
   2. The individual receiving the service.
   3. The date of the service.
   4. The location of service delivery.
   5. The individual providing the service.
   6. The time the service begins and ends.
4. Pursuant to the Illinois Public Aid Code (305 ILCS 5/5-5f(g)), DHS-DRS has contracted an external vendor to implement an Electronic Visit Verification (EVV) aggregator system to capture visit(s) data from provider agencies' alternative EVV System.

2. Homemaker / Home Health Agency Service Providers

2.1. Policy

1. Agencies are required to utilize an EVV system of their choice that meets the requirements at 89 Illinois Administrative Code Section 686.1630 and has the ability to capture 6 elements mentioned in overview above.
2. All service providers employed by an agency shall use the agency's EVV system when providing services to an HSP Customer.
3. Agencies must provide documentation to verify implementation and use of EVV.
4. Agencies must adopt EVV policies and procedures.
5. Agencies must provide training and technical assistance to in-home workers using the EVV system. 
6. Agencies employing fewer than 10 in-home workers can choose to use HSP's approved EVV vendor at no cost to the agency. 
7. Agencies with 10 or more in-home workers must fund the cost of their EVV system at their own expense or can use HHAeXchange free version (NOTE: HHAX free version is not available to agencies at this time. Until the HHAX free version is made available for agencies to use, agencies must use their preferred EVV Vendor for EVV compliance)
8. Agencies who choose to use an alternative EVV vendor, other than the HSP contracted EVV vendor, must require the alternative EVV vendor to submit all visit verification data to HSP's EVV aggregator.
9. Agencies must use an alternative EVV vendor which meets the minimum requirements of the rule, found in 89 Ill. Admin. Code Section 686.1630 (ilga.gov)
10. Technical documentation of aggregator systems transmission guidelines and data format specifications can be found at the HSP Public facing website which can be used by the agency's alternative EVV System vendor.

2.2. Communication

1. During the enrollment of an agency, they will receive a copy of this policy. Agencies are required to review, complete, sign and return it to HSP.
2. Existing agencies will receive a copy of this policy to review, complete, sign and return it to HSP.

2.3. Monitoring

1. All HSP Homemaker Service Agencies and Home Health Agencies are obligated to compile and send provider's visits data to HSP EVV Aggregator.
2. Agencies should send IP visits data to HSP aggregator at least every week or more frequently, for services provided by their IPs.
3. HSP will monitor compliance by checking the visit data reports from HSP EVV aggregator and physical invoices submitted by the agencies monthly.

2.4. Non-Compliance

1. DHS reserves the right to remove agencies from active status if they are not sending providers' visits data to the HSP EVV Aggregator. Providers not in approved status are prohibited from providing services to all HSP customers.
2. A provider's visit will be considered non-compliant.
   1. if it does not include all 6 elements mentioned above in overview of this policy.
   2. If there is any manual entry or adjustment to the original visit (call-in/call-out).
3. Agencies are considered non-compliant if one or more of the following applies.
   1. Not sending their provider's visits data to HSP's EVV aggregator every week.
   2. # of Customers who received HSP services during the last month as reported in physical invoices differs from the HSP EVV Aggregator's data.
   3. # of Provider Hours rendering HSP services during the last month as reported in physical invoice differs from the HSP EVV Aggregator's data.

2.5. Compliance Thresholds

1. Existing Agencies (Enrolled with HSP Aggregator prior to the date mentioned above)
   1. Agencies should be 50% compliant within 6 months of February 18, 2025.
   2. Agencies should be 75% compliant within 1 year of February 18, 2025.
2. New Agencies (Enrolled after the date mentioned above)
   1. Agencies should be 100% compliant within 6 months of their enrollment date.

2.6. Remediation

1. Notices of non-compliance will be sent to the agencies in writing.
2. Such notices may include action steps for the agency to come into compliance, including deadlines for doing so.
3. An agency's failure to come into compliance may result in
   1. Discontinuation of HSP customer referrals to the agency
   2. HSP referral to HFS OIG,
   3. Termination of agency provider enrollment

3. Acknowledgement

1. All agencies must review and acknowledge the above policy.
2. By signing below
   1. The agency acknowledges that they have reviewed the policy in its entirety.
   2. The agency understands the EVV Requirements and agrees to send provider visits data to HSP Aggregator as outlined above.