DHS's New EVV Report Card: Are You Ready for the 15% Rule?

Heads up, Pennsylvania providers! Remember that feeling in school when the teacher handed out the syllabus for a big new class? You’d scan it to see the rules, the grading policy, and exactly what you needed to do to get an ‘A’.

Well, class is in session! The Department of Human Services (DHS) just dropped the syllabus for Electronic Visit Verification (EVV) compliance, effective August 29, 2025, and we've got your study guide right here. This new bulletin affects all providers of Personal Care Services (PCS) and Home Healthcare Services (HHCS).

Don't worry, there's no pop quiz. Let's break down what you need to know to pass with flying colors.

The Test is Open-Book: Meet the EVV Aggregator

The best part about this new "class" is that the test is completely open-book. DHS isn't trying to trick you. They expect you to monitor your own performance.

Your Homework: Providers are now required to use the EVV Aggregator to self-verify your percentage of manually entered visits. This means you can—and should!—be checking your own "grade" regularly to see how you're doing. No more guessing if you’re on the right track. You have the data right at your fingertips.

What's a Passing Grade? The Magic 15% Rule

Every class has a grading scale, and for EVV, the magic number is 15%.

Your goal is to keep your manually entered and verified visits below a 15% threshold each quarter.

Think of it this way: For every 100 visits your agency logs, you want fewer than 15 of them to be manual entries. A manual entry is anything that isn't captured electronically in real-time (like a caregiver forgetting to clock in/out on the app and fixing it later). A few are understandable, but too many will raise a red flag.

From Warning Bells to Detention: The Compliance Timeline

So, what happens if your manual entries start creeping up over that 15% line? DHS has laid out a clear timeline for enforcement.

• January 2026: The First Report Cards. Starting in January 2026, DHS will begin sending out "alerts" to providers who exceeded the 15% threshold in the previous quarter (in this case, Q4 2025). This is your friendly warning bell—a chance to see your score and make improvements.

• Consecutive Non-Compliance: The Parent-Teacher Conference. If your agency exceeds the 15% threshold for two or more consecutive quarters, things get more serious. You'll receive a formal notice and be required to develop a Corrective Action Plan (CAP). This is your "how I'll do better" plan that you'll submit to DHS.

• Persistent Non-Adherence: The Risk of Expulsion. Let's be clear: nobody wants it to get to this point. But for providers—and even individuals in participant-directed services—who continually fail to comply, DHS reserves the right to issue sanctions. This could ultimately include involuntary termination from the program.

Don't Panic! Study Hall is Open.

This isn't meant to scare you; it's meant to prepare you! The bulletin makes it clear that there are plenty of resources available to help you succeed. Your Managed Care Organizations (MCOs) and the DHS itself have tools, guides, and support systems in place.

The key takeaway is to be proactive!

1. Train your team: Make sure every caregiver understands the importance of clocking in and out electronically and in real-time.

2. Monitor your data: Make checking the EVV Aggregator a regular part of your administrative routine.

3. Ask for help: If you see your percentages rising, reach out to your MCO or consult the DHS resources before you get that first alert.

Ultimately, proper EVV is about ensuring integrity and accuracy in the vital services you provide. By staying on top of your numbers, you're not just ensuring compliance—you're strengthening the system for everyone.

You've got this!