Based on a 2010 report, HHS-OIG found in 2006-2007 there were approximately 724 million dollars in improper payments made for Personal Care Services for Medicaid recipients. Improper payments were made due to undocumented services, uncertified PCA workers as well as services billed while members were institutionalized and therefore not authorized to received services. These statistics continue to grow with family and friends continuing to questions whether their loved ones are being provided appropriate care. Recently signed into law by President Obama, the 21st Century CURES Act mandates the use of Electronic Visit Verification (EVV) for in-home visits for home care and personal care visits which is a critical tool to combat potential improper payments and gaps in care commonly seen in this industry.
Section 12006 of the bill requires an EVV solution be put into place for all Medicaid-provided personal care services and home health services prior to Jan 1, 2019 to avoid a tiered penalty in FMAP funding. System requirements listed within the EVV requirements listed within the bill state the following must be verified:
- Date of Service
- Location of Service
- Individual providing service
- Type of Service
- Individual receiving services; and
- Time the service begins and ends.
Although this is a good start to ensure the care and safety of the members, we look forward to contributing to the best practice conversation with response to EVV that will soon begin taking place with the Secretary of Health and Human Services for dissemination no later than January 1, 2018.
Learn more about the benefits of designing your own EVV system and ensure your members are getting the service they deserve.