Knowing that caregivers are where they are supposed to be when they’re supposed to be there has always been a vital need for home care agencies. Being able to track this accountability ensures clients are getting the full range of services they need and reduces fraud risks for agencies when it comes to billing. The invention of EVV (or electronic visit verification) technology has helped home care agencies improve caregiver accountability, and is now being mandated nationwide.
In early December 2016, President Obama signed the 21st Century Cures Act into law, authorizing $6.3 billion in funding, mostly for the National Institutes of Health. Within the act, Section 12006 specifically, it is required for those who provide personal care services and home health care services under Medicaid to use an EVV system for Medicaid-provided personal care services and home health services. States that do not require a system for personal care services and home health services by the mandated dates will face an escalating reduction in FMAP funding. Agencies that provide personal care services are required to be compliant by January 1, 2019, and for all other home health care services, compliance is required by January 1, 2023.
In order to prepare for compliance with the EVV mandate and to ensure no reduction in FMAP funding, it’s important to consider both the incentives and the negative impacts of this legislation.
Incentives for State EVV Adoption
First, let’s talk about the benefits. The incentives for EVV adoption within the 21st Century Cures Act honestly provide more of an opportunity than a forced move for states. The new law provides states up to 90 percent federal funding for design, development and implementation of an EVV system, and up to 75 percent federal funding for operation and maintenance of the system. This funding is available to all states that operate their own EVV system or have a contractor. And for agencies, it is widely known that EVV systems:
- Aid in improving patient care
- Increase caregiver accountability
- Improve client satisfaction
- And free home care providers from the tedium and inaccuracies of paper time sheets and manual billing
Providers in states that adopt the mandate are given an EVV system at no cost and are required to use the system. Benefits to those providers who previously did not rely on electronic tools include the ability to use a “free” system to create back office process efficiencies, eliminate many paper-based processes and more tightly manage their remote workforce.
Negative Impacts for Non-Adopting States
While it seems inexplicable for home care providers that their states not adopt this highly beneficial mandate, there are may be some hold-outs, and there are sanctions for those who choose not to implement. These include:
- States risk losing up to 1 percent of federal medical assistance
- Potential reduction of FMAP funding
- And other sanctions as deemed necessary
Barring any changes in the coming years, the EVV mandate stands to be a highly positive bill for in-home care providers across the country. As industry experts, Arrow Solutions is dedicated to staying abreast of these and other changes that might impact our clients. Contact us any time to learn more about our home care software system and how we can help your agency run smoothly, regardless of the changing regulatory environment.