California Medicaid Electronic Visit Verification (EVV) Solutions

How to stay EVV compliant in California 

Maintaining EVV compliance in California requires an understanding of the state's specific requirements and the available EVV systems. California has implemented an EVV system to comply with the 21st Century Cures Act, which mandates the use of electronic visit verification for personal care and home health services. Providers in California can use the state's designated EVV system or integrate their own solutions with the state-approved data aggregator to ensure accurate data capture and reporting. 

The California Department of Health Care Services (DHCS) provides resources and guidelines to help providers navigate the EVV implementation process. Providers should regularly visit the DHCS EVV webpage and consult the official documentation provided by DHCS to stay updated on any changes or requirements. Staying informed about integration requirements, training materials, and compliance deadlines is essential for seamless operation and adherence to state mandates. 

Benefits of CareTime Software for California EVV  

The CareTime V3 software revolutionizes California's EVV compliance and billing processes, offering unprecedented automation and efficiency. Key features include "Billing While You Sleep," which automates healthcare claims submission based on your set preferences, significantly reducing administrative workload.  

The automated rules engine streamlines claims management by pre-setting rules specific to each payor, preventing declines before they happen. Additionally, the comprehensive dashboard gives a unified view of EVV and claims data, ensuring you're informed and in control. This level of automation and simplicity significantly enhances operational efficiency for California's home care providers. 

CareTime EVV Features for California 

For California, CareTime's EVV system offers advanced features to ensure compliance and streamline operations. These include automated billing, an innovative rules engine for customized payor management, and a comprehensive dashboard for a clear view of EVV and claims data. This functionality simplifies the management process, making it easier for agencies to stay compliant with California's EVV requirements while enhancing operational efficiency.  

Frequently Asked Questions (FAQs) about California Home Care EVV System 

What is Electronic Visit Verification (EVV)? 

EVV is a technology system used to confirm that Home Care services are actually delivered, recording the time, location, and specifics of the service provided. 

Why is EVV required in California? 

California requires EVV to ensure the accuracy of billing for Medicaid-funded Home Care services, enhancing transparency and fraud reduction. 

What type of services are covered under California's EVV requirements? 

Services covered by EVV in California include personal care, home health care, and other Medicaid-funded Home Care services. This encompasses a variety of services such as in-home supportive services (IHSS), personal care services (PCS), and home health services. EVV requirements in California ensure that all eligible services are accurately verified and documented to comply with state and federal regulations. 

What is the deadline for compliance with EVV in California? 

Providers in California were required to comply with EVV requirements by January 1, 2021, in accordance with the federal 21st Century Cures Act. This deadline ensures that all personal care and home health services funded by Medicaid are accurately verified and documented to maintain compliance with state and federal regulations. 

What happens if a provider does not comply with California's EVV requirements? 

Non-compliance with California’s EVV requirements can result in penalties, including the potential loss of Medicaid funding and other sanctions imposed by California Medicaid. Providers are required to adhere to California Medicaid's EVV policies to continue receiving reimbursements for services rendered. 

Where can I find more information about California's EVV requirements? 

For detailed information about EVV requirements in California, providers should visit the California Department of Health Care Services (DHCS) website or contact the state’s Medicaid office directly. 

Home Care Staff Screening & Training Requirements in California 

In California, the screening and training requirements for home care staff are established to ensure high-quality care and safety for clients. Home care workers, such as personal care aides and direct care professionals, typically receive on-the-job training specific to their roles. This training often includes topics such as client rights, emergency procedures, and personal care tasks. 

Certified Nurse Assistants (CNAs): 

• Must complete a state-approved training program. 
• Must pass a competency exam. 
• Required to maintain their certification through continuing education and ongoing employment. 

Home Care Aides (HCAs): 

•  Must complete a criminal background check administered by the California Department of Social Services (CDSS).
• Required to register with the Home Care Aide Registry, which involves submitting an application and undergoing fingerprinting and a Live Scan background check.
• Registration is valid for two years, and aides must renew their registration and complete any required training during this period. 

 California Home Care Facts 

1. EVV System Implementation: California employs an Electronic Visit Verification (EVV) system for Medicaid-funded home care services to ensure accurate billing and reduce fraud, in compliance with a federal mandate.
2. Cost of In-Home Care: The average monthly cost for in-home care in California varies but can be approximately $5,000, depending on the specific services and region.
3. Services Covered: Home care services covered under California's EVV requirements include personal care services (PCS), in-home supportive services (IHSS), and other Medicaid-funded services, monitored to ensure compliance with state and federal regulations.
4. System Flexibility: California allows providers to use either the state's designated EVV system or an approved third-party system for service verification, providing flexibility to choose a system that best fits their operational needs.
5. Mandatory Compliance: Compliance with EVV standards is mandatory for providers to continue receiving Medicaid funding in California.