Responding to a Congressional directive laid our in H.R. 6042, the Centers for Medicare and Medicaid Services (CMS) held a national call for stakeholders of Electronic Visit Verification (EVV) on Wednesday, November 7, 2018. ANCOR and many of its members joined the call, which had over 1,000 participants. CMS recorded the call and shared the transcript online (it may take a few more days to post). Overall, the call identified much pushback and many questions on the scope and applicability of EVV, including whether day services are covered. Read our summary of the call.
EVV is a term used to describe systems set up to ensure that a service/supports visit that has been billed actually occurred as fraud prevention. EVV can describe phone and/or computer-based systems.
As part of the 21st Century Cures Act, Congress has now required states to implement EVV for “personal care services or home care services requiring an in-home visit by a provider” as a fraud prevention measure in order to save federal funds. The Centers for Medicare and Medicaid Services (CMS) is in charge of overseeing the implementation. Visit its dedicated EVV page to access the following resources: CMS May 2018 guidance on the EVV statute, an FAQ on EVV, and the parts of the 21st Century Cures Act that address EVV. July 13 update on resources: CMS has now issued guidance for states seeking "good faith" exemptions to the EVV statute. States are allowed to submit requests from July 1 through November 13, 2018.
The new EVV legislation contains provisions which would reduce the Federal Medicaid Assistance Percentage (FMAP) for states which do not comply with the statute. However, the statute neglects certain implementation challenges arising in states, leaving states vulnerable to non-compliance penalties. This would reduce funding for Medicaid, leaving states - and by extension I/DD supports funded by states – grappling with an unfunded mandate.
LEARN MORE – ANCOR wrote an article elaborating more on these challenges, a summary of CMS' FAQ and guidance, and a memo giving additional background. DisabilityScoop has also reported on ANCOR's concerns.
THE VICTORY: The President Signed the EVV Implementation Delay Bill on July 30, 2018! In response to ANCOR’s and advocates' efforts, EVV implementation has been delayed from January 1, 2019 to January 1, 2020. And it all happened very quickly! Congress introduced legislation to delay the implementation of EVV at the end of May. On June 19, H.R. 6042 passed the House as part of the opioids package under suspension of the rules. The bill then moved to the Senate with the option of either being a stand-alone bill or being attached to larger legislation - it was not required to be part of the Senate opioids package. ANCOR continued its advocacy, leading the Senate to consider H.R. 6042 through the expedited unanimous consent process. Thanks to your advocacy, H.R. 6042 cleared the Senate hotline portion (page 3 of the link) of the unanimous consent process the evening of July 16, 2018. The morning of July 30, the President signed the bill, making it officially the law.
THE WORK THAT REMAINS: ANCOR's next step will be working with CMS and Congress on the key policy issues we have identified during this process - we will also be asking CMS to issue clarification to states about what the EVV delay means. Please contact our Director of Legislative Affairs, Sarah Meek, at email@example.com for more information.