As Medicaid spending on personal care services (PCS) has grown in recent years, so has attention from oversight agencies to the fraud vulnerabilities for this benefit. In 2016, the 21st Century Cures Act mandated that states adopt electronic visit verification (EVV) systems for Medicaid-covered PCS. EVV systems require providers to electronically verify certain information to confirm that scheduled visits actually occurred, which is intended to reduce opportunities for fraud and improper Medicaid payments for PCS. EVV systems also can be used to identify and address gaps in care. This fact sheet describes EVV provisions in the Cures Act and how they are being implemented by states.
Table 1 has been changed from the original posting to correct an error in the state of Washington’s EVV model. It is provider choice, not state-mandated external vendor.