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Iowa Admin. Code r. 441—73.1(249A) & ARC 5597C - Electronic Visit Verification (EVV) System, Medicaid Managed Care and HCBS/Personal Care Services

IowaregulationIowa Department of Health and Human Services (HHS), Iowa Medicaid

What this rule requires your agency to do

  • 1The provider must document each service component in accordance with rule 441—79.3(249A); any service component not so documented shall not be payable. (Iowa Admin. Code r. 441—79.3(249A); ARC 5597C)(Iowa Admin. Code r. 441—73.1(249A) & ARC 5597C - Electronic Visit Verification (EVV) System, Medicaid Managed Care and HCBS/Personal Care Services)
  • 2The provider must capture EVV for personal care services (including consumer-directed attendant care and homemaker services), for which EVV was required beginning January 1, 2021. (ARC 5597C)(Iowa Admin. Code r. 441—73.1(249A) & ARC 5597C - Electronic Visit Verification (EVV) System, Medicaid Managed Care and HCBS/Personal Care Services)
  • 3The provider must electronically verify and document the date of service, the location of service delivery, and the time the service begins and ends. (ARC 5597C)(Iowa Admin. Code r. 441—73.1(249A) & ARC 5597C - Electronic Visit Verification (EVV) System, Medicaid Managed Care and HCBS/Personal Care Services)
  • 4The provider must electronically verify and document the type of service performed for each visit. (ARC 5597C; 42 U.S.C. 1396b(l))(Iowa Admin. Code r. 441—73.1(249A) & ARC 5597C - Electronic Visit Verification (EVV) System, Medicaid Managed Care and HCBS/Personal Care Services)
  • 5The provider must electronically verify and document the individual (member) receiving the service and the individual providing the service. (ARC 5597C)(Iowa Admin. Code r. 441—73.1(249A) & ARC 5597C - Electronic Visit Verification (EVV) System, Medicaid Managed Care and HCBS/Personal Care Services)
  • 6The provider must use an electronic visit verification (EVV) system that the provider checks into at the beginning of and checks out of at the end of each period of service delivery to monitor the enrollee's receipt of care. (Iowa Admin. Code r. 441—73.1(249A))(Iowa Admin. Code r. 441—73.1(249A) & ARC 5597C - Electronic Visit Verification (EVV) System, Medicaid Managed Care and HCBS/Personal Care Services)

Applies to: personal care / home care (CDAC, homemaker, home health services delivered in the member's home or community)

Under the 21st Century Cures Act and Iowa Code chapter 249A, Iowa HHS adopted EVV rules (ARC 5597C amending IAC chapters 73, 78, and 83, effective July 1, 2021). An EVV system must electronically capture six data elements at the point of service delivery: the type of service performed, the individual (member) receiving the service, the date of service, the location of service delivery, the individual providing the service, and the time service begins and ends. EVV applies to personal care services (CDAC, homemaker) effective January 1, 2021, and to home health services. Providers may use an EVV system or, for CDAC, Form 470-4389; service components not documented in accordance with rule 441—79.3(249A) are not payable.

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