Electronic Visit Verification Claims Validation Hard Launch begins April 1, 2026

Electronic Visit Verification Claims Validation Hard Launch begins April 1, 2026
 

Provider Types 26 and 28: Beginning April 1, 2026, any claim for services that requires Electronic Visit Verification (EVV) and is authorized by the Department of Health and Senior Services, Division of Senior and Disability Services (DSDS) (provider types 26 and 28 that provide personal care, advanced personal care, consumer directed services, homemaker, chore, and respite), will be denied if there is no matching visit in the EVV Aggregator Solution (EAS).

PACE Benefit Table

Program of All-Inclusive Care for the Elderly (PACE) Benefit Table

The Program of All-Inclusive Care for the Elderly (PACE) is administered by MO HealthNet and Medicare to provide comprehensive health care, social, recreational, and wellness services to its participants. One of the main goals of PACE is to allow older adults to live safely in their homes instead of nursing facilities. As of May 3, 2024, PACE organizations are active in St. Louis and Kansas City, with a new PACE organization coming to the Springfield area later this year.

Consumer Directed Services Manager Requirement

Consumer Directed Services Manager Requirement

Per the updated Consumer Directed Services (CDS) regulation 19 CSR 15-8.400(1)(D), all CDS providers are required to have a Certified CDS Manager. This CDS Manager is required to pass Certified CDS Manager Test administered by Missouri Medicaid Audit and Compliance (MMAC). All currently enrolled CDS providers will be required to be compliant by December 31, 2024. For more information, review the MMAC Post.

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