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Med-QUEST Provider Memo QI-2223 — Electronic Visit Verification (EVV) Manual Editing and Entry of Visits

Hawaiisub_regulatoryState of Hawaii Department of Human Services, Med-QUEST Division, Health Care Services Branch· effective 2023-01-01

What this rule requires your agency to do

  • 1Provider agency monitoring is based on each 6-digit assigned Medicaid Provider HOKU ID; for agencies with more than one HOKU ID, each account is monitored separately.(Med-QUEST Provider Memo QI-2223 — Electronic Visit Verification (EVV) Manual Editing and Entry of Visits)
  • 2Suspected cases where manual edits were not appropriate and indicate potential fraud will be reported for further investigation to the DHS and Law Enforcement.(Med-QUEST Provider Memo QI-2223 — Electronic Visit Verification (EVV) Manual Editing and Entry of Visits)
  • 3EVV participation is required for HHA, HCA, SD/CD, and I/DD waiver providers in the Medicaid program.(Med-QUEST Provider Memo QI-2223 — Electronic Visit Verification (EVV) Manual Editing and Entry of Visits)
  • 4All SD/CD services must use an EVV system as the source document to capture visits to receive payment for services rendered.(Med-QUEST Provider Memo QI-2223 — Electronic Visit Verification (EVV) Manual Editing and Entry of Visits)
  • 5A manually entered visit (no electronic check-in and check-out; visit information typed in manually) does not meet CMS requirements for an EVV visit and is not compliant; manually entered visits should be a rare occurrence.(Med-QUEST Provider Memo QI-2223 — Electronic Visit Verification (EVV) Manual Editing and Entry of Visits)
  • 6Provider agencies and SD/CD who do not use an EVV solution to record visits for services delivered are subject to corrective action per the memo's monitoring and corrective-action timeline (warnings, action plans, pre-payment review, and financial penalties beginning after the August 31, 2023 target date).(Med-QUEST Provider Memo QI-2223 — Electronic Visit Verification (EVV) Manual Editing and Entry of Visits)
  • 7The Med-QUEST requirement is to have no more than 15% manually edited visits by month per QI provider and I/DD waiver provider agency accounts and SD/CD accounts; manual edits also include manually entered visits.(Med-QUEST Provider Memo QI-2223 — Electronic Visit Verification (EVV) Manual Editing and Entry of Visits)

Applies to: personal care

Sets minimum standards limiting manually edited/entered EVV visits to no more than 15% per provider agency per month, with monthly/quarterly monitoring, corrective-action timelines, and financial penalties for noncompliance.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.