EVV Live-In Caregiver (LIC) Exemption Form Checklist
This checklist was developed based on EVV Live-in Caregiver audits and other feedback from providers. This checklist is meant to help agencies comply with state regulations, mitigate documentation errors, and ensure the proper use of the EVV Live-in Caregiver Exemption. This can be completed by agencies self-auditing their EVV Live-in Caregiver exemptions.
Before you complete this checklist, HCPF recommends that your agency review the
following resources to become familiar with the EVV Live-in Caregiver exemption and
billing requirements:
- The EVV Live-in Caregiver Attestation Exemption Form - EVV Resources - Live-in Caregiver
- Colorado’s Code of Regulations regarding EVV Live-in Caregiver exemptions - 10 CCR 2505-10 8.001
- EVV Live-in Caregiver Memos - EVV Resources - Live-in Caregiver
Once your agency has reviewed these resources, the checklist can be used to
ensure you have complete documentation on file and are billing for an exemption
when active documentation exists.
The EVV Live-In Caregiver Exemption Form Checklist can be found and downloaded on the EVV Resources page under the Live-in Caregiver Resources section.
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