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Electronic Visit Verification (EVV) Provider Attestation

For assisted living facilities (ALFs) and residential care facilities (RCFs), Electronic Visit Verification (EVV) is optional for all personal cares services provided by shift workers employed by the ALF or RCF.

ALFs and RCFs may opt-out of using EVV for documentation of personal cares services by submitting an attestation on the form below to request an exemption from the required use of the EVV system. By submitting this form, you are attesting that the ALF or RCF only bills for personal cares services provided by shift employees and, therefore, is eligible to opt-out from using EVV documentation of personal care services. The ALF or RCF must still fulfill all personal cares documentation requirements.

In order to avoid delays in claims processing and reimbursement, the attestation form must be submitted to the Department by July 31, 2021, and annually thereafter via the provider self-assessment thereafter.

The Department will share attestations with the Managed Care Organizations (MCOs).