Jurisdictional Entities (JEs) are essential partners in implementing CDA’s EVV program. JEs are local organizations that authorize
and pay providers and vendors. Additionally, JEs are responsible for day-to-day oversight of service delivery to program participants. At CDA, our JE partners consist of Managed Care Plans (MCPs) and Multipurpose Senior Services Program (MSSP) Sites. To
support JEs with EVV monitoring and compliance functions, CDA offers the following guidance documents on the
CDA Forms page:
- CDA Form 4049 – Technical Assistance and Intervention Log
- CDA Form 4050 – Electronic Visit Verification (EVV) Policy and Procedures
- CDA Form 4051 – Sanction Request Form, Electronic Visit Verification (EVV) (1/1/2026)
- CDA Form 4051i – EVV Sanction Request Form Instructions