GHP Family notice to home health agencies and caregivers

Geisinger Health Plan (GHP), in partnership with the Pennsylvania Department of Human Services (DHS), is committed to ensuring accurate and timely documentation of services delivered in members’ homes. This notice outlines EVV compliance expectations, monitoring, and opportunities for provider engagement.

We encourage you to review your participating provider agreement with us, specifically Section 1.28: Compliance with Governmental Requirements, which outlines expectations for adherence to applicable laws and regulations from CMS and other federal and state agencies. These requirements may evolve over time, and we appreciate your continued attention to these updates.

EVV Compliance Requirements

Effective January 1, 2025, all providers delivering Personal Care Services (PCS) and Home Health Care Services (HHCS) must maintain at least 85% of EVV records verified without manual edits. This requirement applies across Fee-for-Service and Managed Care delivery systems. You’re encouraged to read the Medical Assistance Bulletin.

Monitoring and compliance

GHP monitors provider compliance quarterly using the EVV aggregator and DOMO Sandata dashboards. Providers can access their EVV compliance reports by logging into the aggregator and selecting the appropriate report options.

We’ll share resources and support options with providers falling below the 85% threshold to help them get back on track. Continued non-compliance may result in corrective action.

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Need help?

GHP is here to support your agency in achieving EVV compliance. For questions or assistance, please contact your Provider Engagement Liaison or visit the DHS EVV resource page.