DHS EVV Provider Survey

Dear Provider,

The 21st Century Cures Act (the Act) was enacted on December 13, 2016. The Act directs States to use an Electronic Visit Verification (EVV) system for Medicaid-financed Personal Care Services and Home Health Care Services. EVV is an electronic system that documents and helps verify, at a minimum, the following: the date when a caregiver visit occurs, the location of service delivery, the caregiver who delivered the service, the member (also referred to as an individual, participant or consumer) who received the service, the service delivered and the begin and end times of service delivery. The primary intention of the Cures Act is to ensure health and safety of members by capturing and validating the receipt of medically necessary services by validating, at a minimum, the six data points mentioned above. The Pennsylvania Department of Human Services (DHS) is utilizing the services and software of Sandata Technologies LLC to deliver the EVV system. DHS is collecting information from you through this survey to support EVV implementation.

Question Title

* 1. Primary EVV Project Contact Information

Name

Title

Provider Agency Name

DBA Name

Address line 1

Address line 2

City

State

Zip Code

Primary Phone

Office Phone

Mobile Phone

Fax

Email address

Medicaid Provider ID (MPI)