CMS Releases Additional EVV Guidance to States

Earlier today, the Centers for Medicare and Medicaid Services (CMS) released further guidance on the implementation of electronic visit verification (EVV) for States. This federal guidance document is in addition to the guidance released May 2018.

In an attempt to answer commonly asked questions, the very short and direct guidance offers clarity to: live-in caregivers; the delivery of medical supplies, equipment or appliances; EVV use within the community; and web-based timesheets.

Web-based EVV is the only model developed by consumers, for consumers. This loss will inevitably deteriorate consumer-directed programs nationwide.”

Kendra Scalia, Director of Policy

This guidance is a win-some, lose-some situation for the community. Here’s the breakdown of what the federal government has said to States:

  • Caregivers who reside with the consumer are not federally mandated to use EVV. States are permitted, at their own discretion, to use EVV for live-in caregivers “to curb fraud, waste and abuse … particularly when using discrete units of reimbursement, such as on an hourly basis.”
  • Delivery, set-up and instruction of use on medical equipment, supplies or appliances are not subject to EVV use.
  • Assistance received in the community is not subject to EVV use. States are permitted, at their own discretion, to capture services rendered in the community.
  • Where services are provided both in the community and at home, only the minutes of service provided at home are required to use EVV.
  • Use of “home” or “community” to capture location is acceptable.
  • Web-based timesheets are not an acceptable form of EVV.

This new guidance creates additional challenges for States and consumers, in particular where services are provided in both the home and the community. While EVV use in the community is not required, recording the hours for purposes of submitting payroll is essential. Should consumers maintain paper timesheets for their activities in the community and an EVV recording system for services in the home, States will need to manage the additional administrative burden this will place on payroll services. There is also significant opportunity for errors to pay.

Stop EVV is disappointed to learn CMS does not agree that a web-based timesheet is an acceptable EVV solution. States such as California, where a web-based timesheet has been in play for many years, will need to re-design their entire payroll structure before the January 1, 2020 implementation deadline approaches.

“The web-based EVV model is the current standard for consumer-directed services,” says Kendra Scalia, Director of Policy at Stop EVV. “It is the only model developed by consumers, for consumers. This loss as an acceptable solution will inevitably deteriorate consumer-directed programs nationwide, rolling back civil right advancements gained through the independent living movement.”

Notably not addressed in the August 2019 guidance document are outstanding questions surrounding the need for EVV systems to capture services in real-time.

Stop EVV is committed to continue its work with national and local groups to find solutions that satisfy the 21st Century Cures Act and maintains the full intent of consumer-directed services.



  1. I’m sure that I share the feelings of many when I say that I’m not with any of this – no matter how they work out the device! To me this is simply a smack in the face to my rights of privacy! I don’t care if I can leave the device at home or take it with me, it feels akin to wearing an ankle bracelet like I’m a criminal! I need home based services due to epilepsy and the multiple surgeries on my spine that limit my movement, but to be honest this is really messing with my mental health. How can I be sure that the government isn’t listening to my conversations or taking pictures of the layout of my home? How do any of know that the government isn’t using the device to play low level sounds that could potentially cause a brain tumor? As I type this I realize that it may sound weird, but being part African American and ALL POOR, my grandfather used to tell me about certain “vaccines” or medications the government would offer to black communities when he was younger. It wasn’t medicine. Obviously. Many guys walked away with syphilis and other diseases or maladies. It’s hard to sleep just thinking of the potential things this machine could be doing. I still say even if everything is ok, I do not wish to be monitored or tracked by a satellite. And it seems to be more of an inconvenience with my nurses and aide having to use it. It’s just the damn principle of the thing! The government is locking up babies at the boarder and monitoring our movements as though we’re not supposed to have lives. I feel like we’re living in a police state!

  2. By keeping our family member at home we are saving taxpayers
    Over 20,000 dollrs a year.( we should be enritled to some of that) .we shouldn’t be called ” employees” when we serve our own.i lost all providers after my son graduated.i couldnt work gainfully so i took on this certification(along with another part time job at minimum wage, so i could work same hrs as my son,also at piece work scale , and be.available for him,)which was made available after my son turned 22,. .the training and every other hoop i have to jump thru for a mere 5000 a year of which i have to pay self employment taxes on on top of paying for this certification.and now THIS. Makes me feel like im the criminal with no due process,our 4th amendment rights are being violated. I know i dont commit fraud but will the REAL criminals who, are committing fraud and spying on american citizens, and who made up this spyware please step forward we need a constitutional attorney. Is this spyware also” made in china”? Cause we know they have been spying on USA and collecting ALL our data..
    What is difference between this evv or paper or web timesheet? Nothing will ever stop the bad guys from doing evil deeds,we shouldnt be the ones paying for the few.it will just continue. And we’ll continue to b more brainwashed into thinking theres an answer,a better way..its time to STOP punishing good decent people and start investigating and arresting REAL criminals.is this about fraud or taking away our rights under the constitution?!?

  3. Forcing people into nursing homes is cruel, unAmerican, and illegal. And it doesn’t save money, quite the contrary. Why would anyone want to do it except because they are sadists?

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