Electronic Visit Verification – Where Are We Now?

Guest blog: Esme Grant Grewal, VP of Government Relations, ANCOR

The American Network of Community Options and Resources (ANCOR), the national trade association for disability service providers and a partner of Foothold Technology, was proud to lead the passage of H.R. 6042, the bill delaying the implementation of electronic visit verification.  As much as ANCOR embraces technology and innovation in our space, we did not feel that the implementation of new Electronic Visit Verification (EVV) legislation was being done thoughtfully and instead we observed the process being rushed without much if any public input.  Although new EVV legislation passed in the 2016 21st Century Cures Act mandated CMS guidance to states by January 2018, we eventually saw the Centers for Medicare and Medicaid Services (CMS) issue guidance in May 2018 with the expectation that all systems would be a go for personal care services by January 2019. The same week that the guidance was issued, Congress responded to this rushed course and pushed for a one year delay of implementation. With ANCOR leading the charge with our allies in Washington working hard to get the delay in place, a bipartisan solution was achieved in a matter of two months (virtually unheard of in Washington, DC) and just last week H.R. 6042 became law as it was signed by the President. If you want to see what the original legislation now looks like with the new changes and delay language, click here.

Next Steps for Electronic Visit Verification

So what’s next for EVV now that the delay is in place? Well first thing’s first – we have requested that CMS release guidance to states on what’s changed given the delay. But that is not all that we have asked of CMS. Now that we have an additional year for implementation, ANCOR is using that time to work with a coalition of national stakeholders and communicate some of our existing concerns with the process. We need greater clarification around the scope of coverage (several services have been indicated as a “case by case” or “state by state” determination). We are also concerned about how states are incorporating required public input opportunities before systems are developed and we are asking for CMS’ help in urging stronger stakeholder processes in all states. Further, we want to be sure that states do not feel incentivized to go with one state contracted provider of EVV – this would mandate one sole provider of EVV services to all disability service providers and may interfere with other technologies they are using. We worked hard to make sure the May CMS guidance allowed for funding support of a state aggregator system that would allow disability service providers to use a multitude of EVV providers and have the state aggregate all of the data. We would like to see this open provider model encouraged even further. Stakeholders are also anxious to know how the data being collected by states will and will not be used – the EVV legislation states and CMS has confirmed that EVV data will be subject to HIPAA. We are just beginning to dive into what that means and if additional guidance from CMS to states is necessary.

The most important thing to remember while these discussions are happening is that most states are still in the process of determining which of the 5 EVV provider systems to select.  So, you could provide the best EVV technology there is, but until a state authorizes it, it is not in compliance with what they select for EVV data collection. This is why we need the help of CMS – and continued help of Congress – to make sure that disability service providers and EVV providers alike have the flexibility they need to provide services in an open market and report the state key information without disrupting the provision of services to people with disabilities. ANCOR is committed to making a difference here so that these new EVV requirements are implemented in the most thoughtful and transparent way possible.

For questions on Electronic Visit Verification, you can always contact Esme Grant Grewal, Esq., at egrant@ancor.org


Foothold Technology is launching an Electronic Visit Verification partnership this fall to help providers stay ahead of the impending legislation. Stay tuned for more details.

Foothold Technology is a proud partner of the American Network of Community Options and Resources – the national trade association representing over 1,000 private providers of community living and employment supports and services to more than 600,000 individuals with disabilities.


About Foothold Technology
Foothold Technology, an electronic record, EHR vendor and human services software provider, offers web-based software for human service providers that eases the burden of documentation, providing agencies with the freedom to focus on their Mission. More than 1,000 agencies nationwide count on Foothold’s AWARDS software to manage their services, including Mental Health, Alcohol & Substance Use Disorder, Intellectual & Developmental Disabilities, Homeless & Housing, Employment & Training, Seniors, Veterans, Youth & Family, and more. Having originated from three agencies in 2000, AWARDS is a complete electronic record and EHR software for human service providers that also supports administrative activities, including facilities maintenance, human resources, scheduling and alerts, audit reports, and automated billing. AWARDS offers full interoperability with any other federally certified system for participation in Health Information Exchanges (HIE) and Regional Health Information Organizations (RHIOs). It is also the only record-keeping system that is certified as both a Behavioral Health EHR software system and an HMIS software package (Homeless Management Information System). With roots and origins in human services, no software vendor is better prepared to support you than Foothold Technology. For more information, visit footholdtechnology.com.