The Wisconsin Department of Health Services (DHS) has released ForwardHealth Update 2021-40, “Electronic Visit Verification Soft Launch Has Been Extended.” This update communicates that DHS required hard launch consequences will not go into effect January 1, 2022. (ForwardHealth Updates 2021-26 and 2021-23 have been revised to reflect this extension.)
With the soft launch extension:
- EVV is still required for Medicaid-covered personal care and applicable supportive home care services and has been since November 2, 2020.
- Provider agencies that are not currently using EVV are out of compliance with current DHS policy.
- Fee-for-service claims without EVV data will be paid.
- DHS has encouraged health maintenance organizations (HMOs) and managed care organizations (MCOs) to continue to pay claims without EVV data until the new hard launch date. This will provide consistency and coordination for provider agencies within the EVV program.
- Services without EVV data will be included in future capitation rate setting development for HMOs and MCOs.
- IRIS (Include, Respect, I Self-Direct) fiscal employer agencies will not deny payment for provider agency claims until the new hard launch date.
- The IRIS non-compliant participant disenrollment process will be delayed. Participants are out of compliance with current DHS policy if their participant-hired workers are not using an EVV system during the soft launch phase.
- Provider agencies choosing to use an alternate EVV system that is not certified should complete the certification process as soon as possible. They are out of compliance with current DHS policy if they are not using an EVV system during soft launch phase.
- In fee-for-service, the Sandata EVV system is not a replacement for Record of Care timesheets until the new hard launch date.
DHS will continue to monitor the status of EVV and will be taking additional actions to further promote EVV usage and provider compliance during the extension.
Payers, provider agencies, and workers should use this extension to become more efficient with EVV, streamline processes, and take additional training as needed.
Wisconsin EVV Customer Care
If you have questions or comments about EVV, please contact Wisconsin EVV Customer Care via email or phone at 833-931-2035. Customer Care hours are Monday–Friday, 7 a.m.–6 p.m. CT.