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Written by: John Wolf on Thursday, March 23, 2017 Posted in:

Protect your state against reduced FMAP with Electronic Visit Verification (EVV)

Passed as a part of the Affordable Care Act was H.R.34, otherwise known as the 21st Century Cures Act.
The intent of this legislation was to “help accelerate medical product development and bring new innovations and advances to patients who need them faster and more efficiently.”

With this bill came one key component mandating the use of electronic visit verification (EVV).

Your agency could face reduced payment without EVV

Section 12006 of the Act imposes a reduction in the FMAP for states that do not implement an EVV solution for personal and/or home health care services that require an in-home visit and are paid for using state-plan Medicaid funds or Medicaid waiver funds- and the penalty increases over time.

  • Personal Care Services must start using EVV by 1/1/2019
  • Home Health Care Services must start using EVV by 1/1/2023

The good news: The Cures Act provides compensation to states who do comply with the mandate. States can be reimbursed up to 90% of implementation costs and 75% of operation/maintenance costs. As new policies take shape in Washington, now is the time to act on this important incentive.

Protection for consumers, providers and payers

Implementing an EVV solution not only avoids reduced FMAP, but benefits and protects all parties involved- payers, providers and consumers alike.

EVV enables payers to proactively prevent waste, fraud and abuse while improving overall program performance and integrity. For providers, EVV provides the ability to maximize revenue, reduce rejected claims, and ensure critical funding source compliance while consumers can continue depending on receiving timely, quality care.

Start your EVV search today

Learn more about EVV by talking to a Mediware Human Services Consultant about the new EVV mobile app as part of the Harmony for Waivers solution. It works for Medicaid claims, claims paid for by grants or the state, or any combination of these funds.

Whether you are already a current Mediware customer or your state is reviewing new alternatives and solutions, now is the time to start a conversation to learn all the implications of Section 12006.