ANCOR requested in a summer meeting with the Acting Director of Medicaid Calder Lynch that the Centers for Medicare and Medicaid Services (CMS), share a list of which states have applied for a good faith delay, and the status of those requests. We are thrilled to see CMS grant the request. Please check the list here regularly as it is being periodically updated and might not reflect requests that have been recently placed.
ANCOR focused in 2019 on obtaining additional guidance on EVV implemenation, in addition to pursuing legislative fixes. We are pleased to see this new guidance released, and will continue to seek solutions to ensure people with disabilities and the providers who support them do not suffer from unintended consequences arising from uncertainty around EVV implementation.
As shared by CMS:
The Centers for Medicare & Medicaid Services (CMS) continues to provide technical assistance to states and other stakeholders to ensure compliance with the 21st Century Cures Act. The Agency has received numerous requests from states and stakeholders to clarify certain electronic visit verification (EVV) requirements.
Today CMS issued an Informational Bulletin that includes a set of frequently asked questions to provide guidance regarding the applicability of EVV requirements to beneficiaries with live-in caregivers, the provision of durable medical equipment, and services rendered partially in the home and partially in the community, where requirement may create privacy concerns.
This guidance also affirms that web-based electronic timesheets alone are not sufficient for ensuring EVV compliance.
This guidance adds additional clarity to previous guidance available on our resource page.
As shared by CMS:
“Section 12006(a) of the 21st Century Cures Act (Cures Act) mandates that states implement electronic visit verification (EVV) for all Medicaid personal care services by January 1, 2020 and for all Medicaid home health care services by January 1, 2023, or otherwise be subject to incremental federal medical assistance percentage (FMAP) reductions. The Cures Act includes a provision that allows states to delay implementation of EVV for up to one year if they can demonstrate they have made a good faith effort to comply and have encountered unavoidable delays. This notice provides states with information regarding the process to request a good faith effort exemption."
In order to inform stakeholders and policy makers of how EVV implementation is unfolding in the states, ANCOR is inviting stakeholders in the community to partake in recurring surveys through which they can share how EVV systems are being set up and/or carried out in their states. We are sharing our findings as they come in - learn more on our dedicated state implementation tracker page! UPDATED: now includes question on whether states have requested a good faith exemption delay.
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 protected] for more information.
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.