With no opposition from the House or Senate, the U.S. Senate unanimously approved legislation of the H.R.6042 bill delay the nationwide deadline for electronic visit verification (EVV) or ( in-home health service bill) in Medicaid-reimbursed personal care services until 2020. President Donald Trump signed Rep. Brett Guthrie’s health care bill into law on July 30th.
According to news reports, the 21st Century Cures Act, initially signed into law in 2016 under the Obama Administration, originally required home care providers and state agencies to begin adopting EVV systems by Jan. 1, 2019, this was in effort to put an end to fraudulent Medicaid Billing. H.R. 6042, was sponsored by Rep. Brett Guthrie (R-Kentucky), pushes that deadline back to Jan. 1, 2020. The bill does specified services from such verification system requirements, including inpatient hospital services and 24-hour residential group home services. The Centers for Medicare & Medicaid Services (CMS) is required to hold at least one hearing by the end of 2019 to solicit comments on the program from stakeholders.
According to reports, H.R. 6042 delays potential penalties providers could have faced for failure to fully adopt or at least make progress toward the implementation of EVV in their operations. States not operating EVV by these deadlines will be subject to reductions in their Federal Medical Assistance Percentage (FMAP) match rate. CMCS published a bulletin in accordance with section 12006(b) of the 21st Century Cures Act (the Cures Act) in order to assist states in implementing electronic visit verification (EVV) systems for Medicaid personal care services (PCS) and home health care services (HHCS).
There are five five models of EVV to consider:
1. Provider Choice Model
2. Managed Care Plan (MCP) Choice
3. State Mandated In-house System
4. State Mandated External Vendor
5. Open Choice Model.
There are six verification criteria of EVV to meet:
- Service type
- Individual receiving the service
- Date of service
- Location of service delivery
- Individual providing the service
- Begin and end times of service