EVV Manual Edits Compliance 85% Requirement for 2025
September 06, 2024
Gregory Estevez
📅 Preparing for 2025: Revised EVV Compliance Standards for 🏠 Care Providers
As 2025 approaches, 🏠 care and personal care providers must prepare for significant changes in 🖥️ Electronic Visit Verification (EVV) compliance. Effective January 1, 2025, the Pennsylvania Department of Human Services will impose stricter standards for EVV accuracy, requiring providers to ensure that 85% of EVV records are verified without manual intervention. Failure to meet this compliance threshold could result in penalties such as 💰 financial fines, increased 📊 monitoring, mandatory 🏫 training programs, or corrective actions including technical assistance or potential disenrollment from state programs.
This document explains these upcoming changes, highlights their distinctions from current practices, and offers guidance on how to maintain compliance.
🔄 Changes in 2025
The primary modification is the elevated EVV compliance threshold. By 2025, providers must verify that 85% of care visits are recorded accurately without necessitating manual edits or corrections. This represents a significant increase from the current 50% threshold, emphasizing the critical importance of ensuring visit verification occurs correctly and in real-time.
Verified visits must 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 times of the service
Any omissions, errors, or subsequent manual modifications—referred to as manual edits—will count against compliance metrics.
📊 Implications of These Changes
The revised requirements extend beyond mere administrative compliance; they are part of a broader initiative to ensure transparency and accuracy in care delivery. The overarching objectives are to mitigate fraud, enhance accountability, and ensure precise documentation for both caregivers and patients. Minimizing manual edits reinforces the reliability of real-time data capture, affirming the integrity of service delivery.
Failure to achieve the 85% compliance benchmark could trigger corrective actions, including technical assistance, more frequent audits or site visits, or even disenrollment from state programs. Therefore, early preparation is essential.
💡 Strategies for Meeting the New Compliance Standards
⚙️ Upgrade Technology Infrastructure
Ensure your EVV system is capable of accurately capturing all six required elements in real-time. Systems that frequently necessitate manual corrections may need to be upgraded to reduce human error and achieve higher compliance rates.📚 Implement Comprehensive Staff Training
Data inaccuracies often originate from insufficient training. Caregivers must be thoroughly educated on accurately logging visits to prevent errors that may require manual edits. Effective training will facilitate the attainment of the 85% compliance standard.📈 Regular Compliance Monitoring
Utilize the EVV Compliance Report available within the Aggregator tool to monitor current compliance levels. By regularly assessing performance, providers can identify potential compliance gaps early and implement corrective measures well before the 2025 deadline.📝 Prepare for Corrective Actions
Should compliance levels fall below the required threshold, be ready to collaborate with the Department of Human Services on corrective action plans. Proactive engagement is critical to preventing small issues from escalating into substantial compliance violations.
⚖️ Comparison with Current Practices
At present, providers benefit from greater leniency, as up to 50% of EVV records may include manual edits without incurring penalties. The updated 2025 regulation significantly reduces this allowance to only 15%, necessitating that the vast majority of visits be recorded accurately at the point of care.
This regulatory shift emphasizes the necessity for real-time verification and a reduction in post-hoc data entry. Providers must prioritize staff training, leverage advanced technology, and maintain consistent monitoring to align with the new standards.
🚀 Proactive Compliance Preparation
With the new regulations taking effect on January 1, 2025, it is crucial that agencies take steps now to ensure readiness. Develop a readiness timeline that includes key milestones such as upgrading technological solutions by mid-2024, completing comprehensive staff training by the third quarter of 2024, and implementing regular compliance monitoring throughout the year. Upgrading technological solutions, investing in caregiver training, and closely monitoring compliance metrics will help mitigate risks of non-compliance and potential penalties.
If you need assistance in updating your EVV system to meet the new compliance requirements, contact us today for a consultation to ensure your agency is prepared for the 2025 changes.
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