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States · Hawaii

Hawaii EVV and Medicaid home care, in plain words.

In Hawaii, most Medicaid home care runs through QUEST Integration health plans, so your agency usually bills the member’s plan.

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Hawaii at a glance

EVV, Medicaid and billing in Hawaii.

Medicaid agencyHawaii Department of Human Services, Med-QUEST Division (MQD). Waiver services for people with intellectual and developmental disabilities are run by the Hawaii Department of Health, Developmental Disabilities Division (DDD).
EVV modelState system with alternate allowed. Med-QUEST contracts Sandata as the state EVV system. Agencies may use Sandata or a certified alternate EVV system; self-directed members must use Sandata.
State EVV systemSandata Technologies (state-contracted Med-QUEST EVV system)
Your own EVV vendor allowed?Yes for agencies, with conditions: the alternate system must meet Sandata’s technical specifications and business rules, pass Sandata certification before going live, and integrate with the Med-QUEST EVV system. The agency pays any development, certification and integration costs. Self-directed members and their workers must use Sandata.
Services that need EVVPersonal care (attendant care, personal assistance Level I and II, respite), DDD waiver services, private duty nursing, skilled nursing, PT/OT/speech therapy and home health aide services, for both agency and self-directed care. Hawaii also chose to include live-in caregivers.
Where you billMost claims go to the member’s QUEST Integration health plan. Fee-for-service claims go through Med-QUEST’s MMIS (HPMMIS); verify the current provider portal name.

Dates that matter: Soft launch 5 Oct to 29 Dec 2020; mandatory EVV use from 30 Dec 2020. Since 1 Oct 2021, health plans and DDD do not pay claims without matching visit data in Sandata. Med-QUEST memos (QI-2223, QI-2305C) limit manual visit edits; check the current threshold.

Licensing: Home care agencies are licensed by the Hawaii Department of Health, Office of Health Care Assurance (OHCA), under HRS 321-14.8; licensing began 10 Aug 2018. Home health agencies hold a separate OHCA license.

Managed care: Yes. Most HCBS/LTSS are delivered through QUEST Integration health plans: AlohaCare, HMSA, Kaiser Permanente, ’Ohana Health Plan (Centene) and UnitedHealthcare Community Plan. ’Ohana’s Med-QUEST contract ends 31 Dec 2026; its members move to another plan on 1 Jan 2027. The I/DD waiver is run by DDD outside the health plans.

Programs that pay for care at home

Hawaii EVV, from the state

Same rules, same tangle

In Hawaii, the visit still gets typed four more times.

The caregiver taps in. The visit goes to Sandata Technologies. Then someone in your office carries it by hand into payroll, into billing, into the chart, and to the family on the phone. Every carry is a chance for the numbers to drift. When they do, Hawaii denies the claim, and you find out weeks later. That is Tangleware™: good tools, and an owner in the middle.

How one tap at the door runs the whole agencyThe mechanism, the nine agents, and Cary®

CareBravo® in Hawaii

Running an agency in Hawaii? Tell us.

CareBravo works with the EVV systems states use, including Sandata, HHAeXchange and Netsmart. Each state approves its own connection, and each program has its own rules, so we confirm what is in place for Hawaii and your programs before you switch anything. If we are not running in Hawaii yet, we will make you an offer to start now while we build it.

Run the Calculator, or ask for the demo and tell us your state.

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Five promises, written like promises.

  1. Nothing stops. Your current system keeps running while CareBravo runs beside it for two weeks on your real data. The Parallel Promise™
  2. 99%, in writing. On Managed Billing, at least 99% of your claims go out without a mistake we caused. If we make one, we fix it free. We cannot promise what a payer decides. Read the guarantee
  3. The floor, stated up front: $250 a month, no seats, no per-user fees, no implementation fee — and corrections never billed twice.
  4. Thirty days’ notice, either way.
  5. Nobody calls unless you ask.

What Hawaii owners ask.

Do I have to use Sandata, or can I keep my own EVV app?

Agencies can use Sandata or their own system, but the other system must pass Sandata certification and send its visit data into the Med-QUEST EVV system before you go live. Your agency pays any setup and connection costs. If your client self-directs their care, their workers must use Sandata.

Will a health plan pay my claim if the visit is missing in EVV?

No. Since October 1, 2021, QUEST Integration health plans and DDD do not pay claims that have no matching visit in Sandata. The check usually runs the same day the plan processes the claim. A claim can also be denied for other reasons, like a wrong service code or member ID, so read the remark codes.

My client is on ’Ohana. What happens in 2027?

’Ohana Health Plan’s Med-QUEST contract ends December 31, 2026. Its members move to a new QUEST Integration plan starting January 1, 2027. Confirm each client’s new plan, make sure your agency is contracted with it, and make sure the new plan’s authorizations show up in EVV before your first January visit.

Does my agency need a state license for non-medical home care?

Yes. Since August 2018, home care agencies in Hawaii must be licensed by the Department of Health’s Office of Health Care Assurance. Home health agencies that give skilled care have a separate license. Health plans will also ask for your license when they review your agency to join their network.

Sources for this guide

Checked 28 Oct 2026. State rules change. Confirm with the Hawaii Department of Human Services, Med-QUEST Division (MQD). Waiver services for people with intellectual and developmental disabilities are run by the Hawaii Department of Health, Developmental Disabilities Division (DDD). before you act.

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We email you the highlights the moment you ask. No call. Nobody calls unless you ask.

See What’s Draining Your Agency →View the demo