CellTrak Blog

The 21^st Century Cures Act has established January 1, 2019, as the deadline for states to establish Electronic Visit Verification (EVV) standards for Medicaid-funded personal care services. As this date draws closer, state Medicaid directors must soon decide on the type of EVV system they’ll require.

Specifically, states will need to decide whether to mandate an open or closed EVV system. These two options are very different from each other, with different implications for home care agencies.

Before states enact these sweeping changes for their constituent agencies, states must understand these differences, so they can endorse the best solution for their agencies’ — and their own — needs.

As the cost of health care and personal services continue to escalate and the concern of fraud in the home health industry continues to grow, agencies are under increasing pressure from payers to provide proof that the in-home services they bill were in fact delivered.

A driving factor in this growing demand for Electronic Visit Verification (EVV) is the 21^st Century Cures Act – which requires states to establish EVV requirements for Medicaid-funded personal care and home care services.

Agencies naturally are concerned. With budgets already stretched thin, there is worry that meeting the EVV mandate will simply add yet another cost that further eats away at profits. And yet, EVV can bring a level of visibility to the delivery and management of care. This visibility may in turn yield unexpected – and potentially significant – gains in productivity, communication, cost, and care outcomes.

In an industry that has been challenged with many uncertainties, Congress approved the 21^st Century Cures Act in early December. The bill passed strongly in both the Senate (94 to 5) and the House of Representatives (392 to 26), and President Obama signed the bill on December 13, 2016.

With a growing number of government and payer mandates calling for home health agencies to validate the accuracy of the care they deliver, Electronic Visit Verification (EVV) has never been more important for the home care industry.

The dog days of summer proved to be far from lethargic for the U.S. Department of Justice this year. In one late-July week, the DOJ charged three people in a $1 billion scheme of conspiracy, obstruction, money laundering and health care fraud. It was the single largest criminal case in the nine-year history of the Medicare Fraud Strike Force.

Going Beyond Simple Proof of Visit

Home care, hospice and community care agencies are moving quickly to adopt electronic visit verification (EVV) solutions. In many cases, their rush stems from a reactive stance as a growing number of states have passed laws mandating the use of EVV. The Federal government has also proposed legislation that would require the use of EVV for personal care services provided under Medicaid.