If your agency bills Medicaid for in-home care, Electronic Visit Verification is not optional. It is federal law, and it traces back to a single piece of legislation: the 21st Century Cures Act. Understanding what the Act requires, and why, is the difference between an agency that treats compliance as routine and one that scrambles every time a payer comes knocking.
The 21st Century Cures Act is a federal law signed in December 2016. Section 12006 of that Act requires state Medicaid programs to use Electronic Visit Verification (EVV) to electronically confirm that certain in-home care visits actually happened. In plain terms, the Cures Act is the reason EVV exists as a mandate, and it is the foundation every state EVV rule is built on. This guide breaks down what the Act requires, who it applies to, the deadlines that already passed, and what your agency needs to do to stay compliant.
What the Cures Act requires
The goal of the EVV mandate is simple: reduce fraud and confirm that billed Medicaid visits were genuinely delivered. To do that, the Act requires that six pieces of information be captured electronically for every applicable visit.
Every visit subject to EVV must electronically record these six data elements:
- Type of service performed
- Individual receiving the service
- Individual providing the service
- Date of the service
- Location of service delivery
- Time the service begins and ends
These six elements are the heart of the mandate. Everything your agency does to comply, from how caregivers clock in to how visits reach the state, exists to capture these accurately and consistently.
Who and what the mandate applies to
The Cures Act EVV requirement applies to two categories of Medicaid-funded, in-home care:
Personal Care Services (PCS) and Home Health Care Services (HHCS). If your agency delivers either under Medicaid, EVV applies to those visits. Private-pay and non-Medicaid services are not governed by the federal mandate, though many agencies choose to use EVV across the board for consistency.
It is worth being precise here: the Cures Act sets the federal floor, but each state implements the details. That means the exact services covered, the technology allowed, and the enforcement approach can vary from state to state, even though the six data elements and the underlying requirement are national.
The deadlines that already passed
The EVV mandate is not upcoming. It is already in effect, and the deadlines are behind us.
| Service type | Federal EVV deadline |
|---|---|
| Personal Care Services (PCS) | January 1, 2020, extended to January 1, 2021 |
| Home Health Care Services (HHCS) | January 1, 2023 |
The PCS deadline was originally January 1, 2020, and was extended by one year to January 1, 2021 for states that demonstrated a good-faith effort to comply. Home health services followed on January 1, 2023. If your agency is not fully compliant today, you are already past due, which is exactly why audits and payer scrutiny have intensified.
What happens if a state does not comply
The Cures Act enforces the mandate through funding, not fines to individual agencies. States that fail to implement EVV face incremental reductions in the federal share of their Medicaid funding. That financial pressure flows downhill: states enforce EVV through their Medicaid programs and Managed Care Organizations, which in turn hold agencies accountable through claim denials, audits, and corrective action. So while the penalty technically lands on the state, your agency feels it through stricter oversight and payment requirements.
How states let agencies comply
Because each state chooses how to implement EVV, agencies generally encounter one of a few models. A state may run its own EVV system that agencies must use, contract a single vendor for everyone, or allow an open model where agencies choose their own EVV solution as long as it meets requirements and transmits data to the state aggregator.
The practical takeaway: whatever model your state uses, your EVV data has to reach the state’s aggregator in the required format. An agency can look perfectly compliant on its own dashboard while the data the state actually needs never arrives. Confirming that your system transmits correctly is a core part of compliance, not an afterthought.
What your agency needs to do to stay compliant
Compliance is less about paperwork and more about capturing clean data at the point of care, every time. In practice that means capturing all six data elements on every applicable visit, verifying the caregiver and location at the point of care, keeping manual edits low and documented, confirming your data reaches the state aggregator, and retaining records so you can prove compliance during an audit. Get those habits right and EVV becomes routine instead of a recurring fire drill.
The agencies that struggle are usually the ones stitching EVV together with disconnected tools. The ones that stay compliant use a system built for it. For a deeper walkthrough of audit readiness, see our guide on how to pass an EVV audit, and if you are new to the topic, start with what EVV is and why it matters.
How software keeps you compliant without the headache
Meeting the Cures Act requirement comes down to capturing the six data elements cleanly and getting them to the state, visit after visit. That is far easier with a platform built for it. CompanyOn is practice management software for care on the go, trusted by 1K+ practices across Canada & US with a 4.8/5 average rating. It captures GPS-verified visits (including offline in low-connectivity homes), surfaces exceptions in real time, and connects verified visits to billing, all protected with HIPAA and PIPEDA aligned security and SSL protection. If EVV is central to your agency, see how it fits your workflow on our home care agency EVV solutions page.
Frequently asked questions
What is the 21st Century Cures Act in relation to EVV? The 21st Century Cures Act is a 2016 federal law whose Section 12006 requires state Medicaid programs to use Electronic Visit Verification for certain in-home care. It is the legal basis for the EVV mandate across the United States.
Is EVV mandatory? Yes. For Medicaid-funded Personal Care Services and Home Health Care Services, EVV is federally mandated under the Cures Act. The deadlines have already passed, so compliance is expected now.
What are the six EVV data elements required by the Cures Act? Type of service, individual receiving the service, individual providing the service, date of service, location of service, and the time the service begins and ends.
When did EVV become required? Personal Care Services had a deadline of January 1, 2020, extended to January 1, 2021 for states showing good-faith effort. Home Health Care Services followed on January 1, 2023.
What happens if an agency is not EVV compliant? States that do not implement EVV face reductions in federal Medicaid funding, and they pass that pressure to agencies through claim denials, audits, and corrective action plans. See our guide on common EVV mistakes and how to prevent them.
Does the Cures Act EVV rule apply to private-pay clients? No. The federal mandate applies to Medicaid-funded PCS and HHCS. Many agencies still use EVV across all clients for consistency, but private-pay visits are not governed by the Cures Act.
Make Cures Act compliance routine
EVV compliance should not be the thing that keeps you up at night. Book a demo to see how CompanyOn captures clean, compliant visit data and keeps your agency audit-ready, or start your free 14-day trial and run it on your own caseload.
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This article is general information, not legal advice. EVV requirements vary by state, so confirm the specifics with your state Medicaid program.
