Looming Deadline for Electronic Check-in for Home Care Workers Raises Concerns

Starting in 2019, providers of home health care services will be required to clock in electronically with Medicaid prior to performing services. However, disability rights advocates and a bipartisan group of senators are calling for the state-by-state rollout of these Electronic Visit Verification (EVV) programs to be delayed. Among their concerns is that under the current timetable, individuals who receive Medicaid services will not have a voice in how the EVV programs are implemented.

Congress enacted the requirement in 2016, as part of the 21st Century Cures Act, as a way to prevent caregivers from billing Medicaid for fraudulent home visits. The law obligates each state to develop its own EVV system.

On May 16, the Centers for Medicare and Medicaid Services (CMS) released long-awaited guidance for states on creating their EVV systems. Most prominently, the guidance specified that only personal care and home health care service providers must comply with the EVV requirements, responding to speculation that the law could be interpreted to include employees at nursing homes and other around-the-clock facilities.

The guidance further clarified that states can create their own EVV systems, as long as the system records certain basic information about the home care visit.

In response to privacy concerns, the guidance also states that the system doesn’t require GPS tracking of caregivers or other systems to monitor their movements once they have clocked in, provided that it tracks when caregivers begin and end their shifts. This issue has triggered significant worries from disability advocates, as some states have already launched programs that include GPS technology.

“We have a lot of concerns around how these are being implemented and the video and audio recording function that is coming up in some states, including Ohio,” Nicole Jorwic, director of rights policy for The Arc, told Disability Scoop. “I do think the CMS guidance will provide some support to states, but it still leaves a lot of discretion at the state level. There’s no reason to think these things couldn’t still continue.”

Six days after the release of the CMS guidance, Senators Lisa Murkowski (R-AK), Rob Portman (R-OH) and Sherrod Brown (D-OH) introduced bipartisan legislation to delay compliance of the requirement for a year, to January 1, 2020. Companion legislation has also been introduced in the House of Representatives.

“This is too important to rush – we must take the time to get it right,” said Sen. Brown in a joint news release. “Our legislation will ensure communities across the state – whether they are rural or urban – have the time and flexibility they need to get electronic verification systems up and running, and ensure that the Ohioans who rely on Medicaid for personal care services, and those who deliver those services, have the opportunity to make their voices heard during the process.”

Click here to read the CMS guidance.