The American Network of Community Options and Resources (ANCOR), the national trade association for disability service providers and a partner of Foothold Technology, was proud to lead the passage of H.R. 6042, the bill delaying the implementation of electronic visit verification. As much as ANCOR embraces technology and innovation in our space, we did not feel that the implementation of new Electronic Visit Verification (EVV) legislation was being done thoughtfully and instead we observed the process being rushed without much if any public input. Although new EVV legislation passed in the 2016 21st Century Cures Act mandated CMS guidance to states by January 2018, we eventually saw the Centers for Medicare and Medicaid Services (CMS) issue guidance in May 2018 with the expectation that all systems would be a go for personal care services by January 2019. The same week that the guidance was issued, Congress responded to this rushed course and pushed for a one year delay of implementation. With ANCOR leading the charge with our allies in Washington working hard to get the delay in place, a bipartisan solution was achieved in a matter of two months (virtually unheard of in Washington, DC) and just last week H.R. 6042 became law as it was signed by the President. If you want to see what the original legislation now looks like with the new changes and delay language, click here.
Next Steps for Electronic Visit Verification
So what’s next for EVV now that the delay is in place? Well first thing’s first – we have requested that CMS release guidance to states on what’s changed given the delay. But that is not all that we have asked of CMS. Now that we have an additional year for implementation, ANCOR is using that time to work with a coalition of national stakeholders and communicate some of our existing concerns with the process. We need greater clarification around the scope of coverage (several services have been indicated as a “case by case” or “state by state” determination). We are also concerned about how states are incorporating required public input opportunities before systems are developed and we are asking for CMS’ help in urging stronger stakeholder processes in all states. Further, we want to be sure that states do not feel incentivized to go with one state contracted provider of EVV – this would mandate one sole provider of EVV services to all disability service providers and may interfere with other technologies they are using. We worked hard to make sure the May CMS guidance allowed for funding support of a state aggregator system that would allow disability service providers to use a multitude of EVV providers and have the state aggregate all of the data. We would like to see this open provider model encouraged even further. Stakeholders are also anxious to know how the data being collected by states will and will not be used – the EVV legislation states and CMS has confirmed that EVV data will be subject to HIPAA. We are just beginning to dive into what that means and if additional guidance from CMS to states is necessary.
The most important thing to remember while these discussions are happening is that most states are still in the process of determining which of the 5 EVV provider systems to select. So, you could provide the best EVV technology there is, but until a state authorizes it, it is not in compliance with what they select for EVV data collection. This is why we need the help of CMS – and continued help of Congress – to make sure that disability service providers and EVV providers alike have the flexibility they need to provide services in an open market and report the state key information without disrupting the provision of services to people with disabilities. ANCOR is committed to making a difference here so that these new EVV requirements are implemented in the most thoughtful and transparent way possible.
For questions on Electronic Visit Verification, you can always contact Esme Grant Grewal, Esq., at [email protected]