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Attention home health providers:
This provider alert is an update and reminder of the Health Care Authority’s (HCA) implementation of electronic visit verification (EVV) for home health care services (HHCS).
Who do the EVV HHCS requirements not apply to?
HCA decided that EVV HHCS requirements do not apply to Medicare crossover claims. (For reference, see the Frequently Asked Questions updated September 2023 on HCA’s EVV HHCS website.)
As a reminder, EVV HHCS requirements do not apply to Private Duty Nursing (PDN) services performed by and billed by individuals or agencies. PDN services do not fall under intermittent home health care services. (For reference, see the Private Duty Nursing for Children Billing Guide, page 8.)
Note: The Department of Social and Health Services (DSHS) has implemented EVV for personal care services and respite care services. The EVV requirements for these services are found on DSHS’ Electronic Visit Verification website.
Is there a period of technical assistance for reject/denial of claims?
Yes. On September 29, 2023, HCA sent a provider alert stating that due to implementation challenges, HCA determined that claims and encounters without the EVV HHCS data elements will not be rejected or denied for service dates of January 1, 2024, or later. Instead, HCA will enter a period of technical assistance to ensure home health providers are able to provide the necessary data elements and continue to serve the Medicaid population.
HCA extends this same period of technical assistance to the enrollment of individual home health servicing providers with HCA.
What is the status of the EVV rules?
On September 21, 2023, HCA sent out a rulemaking notice for proposed rulemaking and notice of public hearing related to EVV HHCS. (See HCA’s Upcoming public hearings website for more information.)
For more information
Additional information can be found on the EVV HHCS website. Please send questions or concerns to HCA via the EVV HHCS email box: HCAEVVHomeHealth@hca.wa.gov.
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