The Vendor is required to provide an electronic visit verification (EVV) system is to confirm that individuals are receiving the services authorized in their care plans, prevent improper billing or payments, protect against fraud, and enhance program oversight.
- The EVV system must:
• Have the capability of supporting approximately 55,000 users and processing 12.5 million service records annually.
• Comply with the 21st Century Cures Act EVV requirements, using GPS for location verification.
• Provide an alternative method for collecting service location if internet or cellular access is unavailable, not relying on a landline.
• Integrate prior authorization data from the home and community-based services (HCBS) Data Management Contractor and Medicaid’s Fiscal Intermediary Contractor.
• Meet CMS Streamlined Modular Certification criteria.
• Enable configuration to support business rules for various programs.
• Provide users with real-time access to service data.
• Allow records to be edited and voided for at least two years from the date of service while maintaining a log of all changes made to the original record.
• Include a service audit tool to detect potential fraud and out-of-state services.
• Map services collected through EVV with the ability to filter by participant, worker, and provider; each participant’s home location must be identified on the map.
• Track provider compliance with agency EVV utilization requirements and provide compliance data to agency and its designees.
- Services recorded by EVV include:
• Personal care services (PCS)
• Vocational and day services, including transportation
• Support Coordination
• Supported Independent Living in-home visits
• Home health care services (HHCS)
• Participant visits by the Long-Term Care (LTC) Access Contractor
- Monitoring data files submitted by third-party EVV vendors on an on-going basis to ensure compliance with agency requirements and providing technical assistance as needed to providers and their third-party EVV vendors.
- Provide a configurable system architecture to support various programs with changing policies and business rules.
- Questions/Inquires Deadline: November 10, 2025
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