Electronic Visit Verification Exempt Visit Guidance (Version 4)

What this rule requires your agency to do

• 1EVV Exempt services must not be billed through the Fee-For-Service HHAeXchange contract; they must be billed directly to Gainwell through the NJMMIS portal using the correct Place of Service code (billing exempt services through the DDD FFS HHA contract affects the manual exception rate and results in non-compliance).(Electronic Visit Verification Exempt Visit Guidance (Version 4))
• 2All EVV Exempt visits must still be documented to be compliant with Medicaid standards, via the Community Based / Individual Supports log, capturing the date, start and end time, activity, and how the activity helps the individual reach their support outcome.(Electronic Visit Verification Exempt Visit Guidance (Version 4))
• 3Support Coordinators must note in the service description whether each service is EVV required, EVV exempt, or EVV required intermittently.(Electronic Visit Verification Exempt Visit Guidance (Version 4))
• 4If any part of an EVV service is performed in the home, EVV is applicable for the entire visit; only visits performed strictly in the community qualify for the community-only exemption.(Electronic Visit Verification Exempt Visit Guidance (Version 4))
• 5For live-in caregiver exemptions, an EVV Live-In Worker Attestation form is required; the Support Coordinator must complete it at service plan development, whenever there is a change in status, and annually thereafter, obtain proof of address, and upload it to iRecord.(Electronic Visit Verification Exempt Visit Guidance (Version 4))