U.S. lawmakers have introduced legislation to delay the mandated implementation of electronic visit verification (EVV) in home care by one year.
Under current provisions in the 21st Century Cures Act, a $6.3 billion piece of legislation signed into law under the Obama administration, Medicaid-reimbursed home care providers must begin adopting EVV systems before Jan. 1, 2019. The EVV requirement aims to curtail fraud and abuse by arming caregivers with approved mobile applications and other methods to prove appropriate care was delivered on time and in full.
How states choose to implement EVV is largely up to them, and some states have already adopted and implemented measures. States that don’t comply risk facing federal funding reductions, though penalties can be avoided if states show “good faith” progress or experience unforeseen technical delays.
Citing a need to give states and home care providers more time to succesffully roll out EVV, Senators Lisa Murkowski (R-AK) and Sherrod Brown (D-OH) introduced a bipartisan bill to push the deadline back one full year, to Jan. 1, 2020. EVV has the potential to improve patient care by validating the delivery and billing of home care services, but states simply need more flexibility to get systems up and running, the senators argue.
“This is too important to rush—we must take the time to get it right,” Sen. Brown said in a statement. “Our legislation will ensure communities across [Ohio]—whether they are rural or urban—have the time and flexibility they need to get electronic verification systems up and running, and ensure that the Ohioans who rely on Medicaid for personal care services, and those who deliver those services, have the opportunity make their voices heard during the process.”
A similar bill, sponsored by Rep. James Langevin (D-RI) and Rep. Don Young (R-AK) was also introduced in the House.
States are required to make real progress toward EVV implementation by the start of next year to avoid penalties, but they don’t necessarily have to have systems fully in place. That’s an important distinction, Mark Battaglia, president and CEO of CellTrak Technologies, Inc., told Home Health Care News.
Chicago-based CellTrak offers care delivery management tools that include EVV. It has customers—including Addus HomeCare Corporation (Nasdaq: ADUS)—in the United States, the United Kingdom and Canada.
“As long as [states] are making progress, [the Centers for Medicare & Medicaid Services] has the flexibility to not withhold payments from them,” Battaglia said. “[The act] does not actually require that they have systems fully up and running … that’s maybe an overstatement of what people think.”
Nearly three dozen states have already finished or taken significant steps toward putting verification systems in place, according to the Partnership for Medicaid Home-Based Care. The list includes Ohio, which awarded a $66.5 million contract to New York-based Sandata Technologies to administer and help roll out its EVV system. That rollout was reportedly met with a “firestorm” of complaints, however.
The majority of states that have taken steps have chosen to adopt “open models” for EVV, meaning home care providers are given the option to choose from a variety of certified EVV systems and vendors. But at least six states—Alabama, Connecticut, Kansas, Oklahoma, Rhode Island and South Carolina—have chosen “closed models” that require providers to use a single, specific EVV solution.
“Progress seems to be pretty good, which is one of the reasons why [these bills are] a little surprising to us,” Battaglia said. “Why would we opt to delay, especially given the safety valve that CMS already has?”
The open model is largely preferred by home care industry because it allows multi-state operators to use one EVV solution instead of relying on patchwork of state-by-state systems.
EVV systems must be able to verify the type, date, location and duration of a home care service provided. Systems must also be able to verify who gave and received services.
“People are getting older across the globe,” Battaglia said. “We believe that the two most important things to meet their needs are the caregivers who are delivering the care and then the technology that connects those caregivers to the rest of the health care system.”
After being introduced Tuesday, the bills were referred to the Senate Committee on Finance and the House Committee on Energy and Commerce.
Written by Robert Holly