Electronic Visit Verification
Public Comment and Input Information
EVV Good Faith Extension Request Approved
Effective November 6, 2019, the Centers for Medicare and Medicaid services has approved Oklahoma for an extension for the implementation of a statewide EVV system in accordance with 12006(a)(4)(B) of the 21st Century Cures Act.
Electronic Visit Verification Mandate – 21st Century Cures Act Section 12006
Enacted on December 13, 2016, the CURES Act is considered to be landmark legislation for healthcare quality improvement through innovation. It includes funding to combat the opioid epidemic, reauthorizes the National Institutes of Health and funds new research, streamlines the development of new drugs, provides continued support for the interoperability of health information systems, and it sets forth significant behavioral health provisions including strengthening mental health parity. Section 12006(a) of the 21st Century Cures Act mandates that states implement EVV for all Medicaid personal care services (PCS) and home health services that require an in-home visit by a provider.
States must require EVV use for all Medicaid-funded PCS by January 1, 2019, and Home Health by January 1, 2023. Otherwise, the state is subject to incremental Federal Medicaid Assistance Percentage (FMAP) reductions up to 1 percent unless the state has both made a “good faith effort” to comply and has encountered “unavoidable delays."
The CURES Act is very specific about the components of each PCS or Home Health visit to be verified; they include:
- The type of service performed;
- The individual receiving the service;
- The date of the service;
- The location of service delivery;
- The individual providing the service; and
- The time the service begins and ends.
In obligation to the public meetings act, the OHCA will host stakeholder meetings to include input from members, family caregivers and individuals who furnish personal care services or home health services.
EVV Implementation Delay UPDATE - H.R. 6042
H.R. 6042 delays by one year (to January 1, 2020) the Medicaid federal matching rate reduction that is scheduled to take effect for states that fail to require an electronic visit verification system for personal care services. The bill also excludes specified services from such verification system requirements, including inpatient hospital services and 24-hour residential group home services.