Ready for 2025? New EVV Compliance Rules for Home Care Providers

As 2025 approaches, home care and personal care providers need to prepare for major changes in Electronic Visit Verification (EVV) compliance. Starting January 1, 2025, Pennsylvania’s Department of Human Services is raising the bar for accuracy, and providers must ensure that 85% of their EVV records are verified without any manual edits. Falling short of this requirement could mean penalties and corrective action.

In this blog, we’ll break down what these changes mean, how they differ from what you’re doing today, and how to get ready to stay compliant.

What's Changing in 2025?

The key change is the new EVV compliance threshold. By 2025, providers must ensure that 85% of their care visits are logged accurately, with no need for manual corrections or edits. This is a significant jump from the current 50% limit, meaning it will be more important than ever to make sure visits are verified correctly in real-time.

Verified visits are visits that include all six required elements:

• The type of service provided

• The name of the individual receiving the service

• The date of service delivery

• The location of service delivery

• The name of the individual providing the service

• The start and end time of the service

Any mistakes, missing information, or manual adjustments after the visit—known as manual edits—will count against your compliance.

Why Do These Changes Matter?

These stricter requirements aren’t just about paperwork; they’re part of a larger effort to ensure transparency and accuracy in how care is delivered. The goal is to reduce fraud, improve accountability, and make sure that both caregivers and patients are properly documented. By minimizing manual edits, you’re showing that your services are being recorded accurately and in real time.

Failure to meet the 85% threshold could result in corrective action, including technical assistance, monitoring, or even disenrollment from certain programs. That’s why it’s essential to start preparing now.

How to Prepare for the New Requirements

1. Invest in Better Technology
Make sure your EVV system is up to date and capable of capturing all six required elements in real time. If your current system frequently requires manual corrections, consider upgrading to a more accurate solution that minimizes human error.

2. Train Your Staff
Inaccuracies often stem from a lack of proper training. Make sure your caregivers understand how to correctly log their visits and avoid common mistakes that could lead to manual edits. This will help you reach the 85% compliance threshold more easily.

3. Monitor Your Progress Regularly
Use the EVV Compliance Report available in the Aggregator tool to track your current compliance levels. By regularly checking your progress, you can identify issues early and take steps to correct them before 2025 arrives.

4. Be Ready for Corrective Actions
If your compliance levels fall short, be prepared to work with the Department of Human Services on a corrective action plan. It’s better to be proactive and stay ahead of any issues before they turn into bigger problems.

What’s Different from What You’re Doing Now?

Currently, providers are allowed more flexibility, with up to 50% of their EVV records being manually edited without penalty. The 2025 update drastically reduces this margin to just 15%, meaning that the majority of your visits must be recorded accurately the first time.

This shift emphasizes the importance of real-time verification and minimizing manual data entry after the fact. Providers will need to focus more on training, technology, and consistent monitoring to stay compliant.

Stay Ahead of the Game

With these new rules set to take effect on January 1, 2025, now is the time to ensure your agency is fully prepared. Upgrading your technology, investing in staff training, and closely monitoring your compliance levels will help you avoid penalties and stay on top of the new requirements.

Need help getting your EVV system ready? Contact us today for a consultation and ensure your agency is prepared for the 2025 compliance changes.

Source

https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/MAB2024082301.pdf