EVV aggregator changes in 2026: what Illinois's move to the HHAeXchange portal teaches every agency

What is an EVV aggregator, and why does a change affect claims?

An EVV aggregator is the state’s central system where visit records from every EVV vendor land, so the state and its managed care plans can match claims to visits. In Illinois that system is HHAeXchange, named by the Department of Healthcare and Family Services as the statewide EVV vendor when the state implemented electronic visit verification effective December 31, 2023².

The claim connection is direct. Illinois’s September 2025 EVV town hall describes the problem case as claims to Illinois Medicaid, the Medicaid MCOs, DSCC or DDD for EVV in-scope procedure codes that do not align with EVV data within HHAeXchange³. If the visit isn’t in the aggregator, or is there with a different date, service or caregiver than the claim, the claim is what suffers.

So when a state changes aggregators, or moves a new provider group into one, it changes where your visit data has to be before you bill. Your EVV app can work perfectly and your claims can still fail, because the match now happens somewhere new. The EVV billing page explains the match itself.

What did Illinois require of providers in early 2026?

Three things on a fixed timeline: attend an information session, submit an enrollment form by January 19, 2026, and be ready for the HHAeXchange EVV Portal to go live on March 2, 2026¹. The welcome letter, dated October 28, 2025 and sent to Home Services Program agencies by the Division of Rehabilitation Services with HFS, called the portal the only no-cost offering to program providers¹.

Every provider had to choose a path. All providers must either use the HHAeXchange EVV Portal or ensure their chosen EVV vendor connects with HHAeXchange to aggregate EVV data¹. Providers on the free Sandata portal would be migrated to the free HHAeXchange portal, and providers on a paid Sandata portal could keep it, which the state would then treat as a third-party system¹.

The enrollment form was the step people missed. All in-home service providers without an HHAeXchange portal had to complete it by January 19, 2026, and the letter says this is required for all providers, even those using a third-party EVV system¹. Agencies serving both the Department on Aging and DRS filed one form naming both payers; providers that already had portal access for State Plan Medicaid didn’t need a new one¹.

To use it for your own state, copy the milestones and put your state’s date beside each one as its notice sets them.

If you keep your own EVV vendor, what still has to happen?

Your vendor has to complete integration with the aggregator and transmit visit data, and you still have to enroll. The town hall slides spell it out: providers may keep their third-party vendors, but the agency and its vendor must then complete integration activities and transmit visit data for aggregation³. The letter adds that you and your vendor must meet the integration requirements and the business rules for third-party systems¹.

Two details change the timeline. Vendors already integrated with HHAeXchange don’t repeat testing, and production credentials follow the attestation and enrollment survey³. A vendor that hasn’t integrated tests first, which is where the two-week gap in the example below comes from.

And the data has to cover everyone. Illinois told agencies to ensure visit data is in HHAeXchange for all customers, regardless of whether DoA, DRS or an MCO is paying for the services³. If your vendor only sends the visits for one payer, the rest of your claims have nothing to match against.

Which visits get stuck during the overlap, and how do you find them?

The visits performed after go-live but before your vendor’s feed is live, and the visits that arrive with a payer, service code or authorization the aggregator doesn’t recognize. The post on EVV exceptions and the claims that follow owns the exception reasons and the claim hold; here the point is the transition-specific cause.

Illinois had a preview in 2024. The HFS notice from June 2024 reported EVV rejections for home health care visits caused by incomplete authorization data, with a fix expected within about two months, and moved the Department on Aging go-live to November 1, 2024². Transitions slip, and the visits in the slipped weeks are the ones that end up unmatched.

To find them, pull two lists each week: visits your EVV system shows as complete, and visits the aggregator shows as received. The difference is your unmatched queue. Sort it by payer and caregiver, because a missing payer link or an unlinked worker ID takes out a whole block of visits at once.

How do you test the visit-to-claim match before the first billing cycle?

Send a small batch first and reconcile it line by line before you release the rest. Pick one week of visits for one payer, confirm each appears in the aggregator with the right member, date, service and units, then bill only those and read the response. If they pay, release the next payer. If they don’t, you’ve found the problem on a handful of claims rather than a month’s worth.

The elements to compare are the ones the state measures. Illinois’s compliance reporting asks whether a visit captures all six elements required under the 21st Century Cures Act, whether there were manual edits, whether staff were trained before service delivery and whether there has been a change in vendor³. A vendor change is on that list because the state knows what it does to match rates.

Claim submission during a transition is slower by design: a dedicated biller holds claims for unmatched visits, releases matched ones and keeps the hold list in front of the owner every week. The home care billing overview shows where EVV sits in that workflow, and the Illinois home care page lists the state’s programs and payers.

What should the first 60 days of monitoring look like?

The first 60 days of monitoring should run weekly and against the state’s own threshold, tracking the share of visits matched in the aggregator per payer, so a drop shows up long before the quarterly compliance figure the state measures. Illinois monitors an EVV compliance percentage by state fiscal year quarter and reaches out to agencies under 75%; the policy the town hall previewed escalates from mandatory training for one quarter under 75% to a formal Compliance Action Plan for two and a referral to the HFS Office of Inspector General for three³. The state moved from year-to-date to quarterly measurement because year-to-date hides recent improvement or decline³.

Your internal number should be the same one: visits matched in the aggregator divided by visits performed, per payer, per week, tracked alongside EVV-related claim rejections and the age of your oldest unmatched visit. Read the Know Your Numbers report Illinois sends administrators, or your state’s equivalent, against your own count³. Where they disagree, the aggregator is right and your feed is wrong.

What to do this week

1. Find the last EVV notice from your state Medicaid agency and write its date for each milestone in the table above.
2. Ask your EVV vendor, in writing, whether it is integrated with your state’s aggregator today and, if not, when testing starts.
3. Confirm your enrollment with the aggregator, even if you keep your own vendor, and file the confirmation.
4. Build the weekly two-list reconciliation: visits performed versus visits received by the aggregator.
5. Put the state’s compliance threshold on your weekly report next to your own match rate.