As the 2019 deadline approaches for state Medicaid offices to comply with the 21st Century CURES Act, slower-moving states are learning and benefiting from the mistakes made by early-adopters. As we have detailed in the past, three of the four popular pathways for states to comply with the EVV mandate part of the law are bad news for home care providers. (See our 8/16/17 interview with Sandata CEO Tom Underwood, "Four EVV Models States Might Choose; Three Lead to Disaster." Some states had to implement one of the three models Underwood warned against in order to see their inherent difficulties.
According to a letter to state Medicaid directors obtained by HCTR, Virginia and Missouri are moving in the direction of the "Neutral Aggregator" model, which offers the twin benefits of freedom of choice to providers and lowest cost to states. Aggregator software is built or, more often, contracted out by the state and can accept and verify EVV data from any vendor and deliver it to state systems in a single format. The provider of the aggregator software is not itself an EVV vendor. In the letter, Jared Schneider, CEO of Caretime, describes the benefits of the Neutral Aggregator model.
"This model is really the best of both worlds. More importantly, CMS has clarified that it qualifies for Federal funding match." He quotes this excerpt from a May, 2018 CMS guidance, found at https://www.medicaid.gov/Federal-PolicyGuidance/Federal-Policy-Guidance.html.
18. Q: Is enhanced Federal Match available to states for the implementation of a higher level system that unifies multiple operational vendors (e.g., for the purposes of collating data from providers’ EVV vendors at the state level, such as an aggregator system)?
A: Yes. CMS will consider enhanced matching funds for higher level systems components and vendors for Medicaid enterprise IT projects that adhere to the principles and requirements described in Federal Policy Guidance found at SMD # 16-009 (June 27, 2016) Re: Mechanized Claims Processing and Information Retrieval Systems – APD Requirements; and SMD # 16-010 (August 16, 2016) RE: CMS-2392-F Mechanized Claims Processing and Information Retrieval Systems – Modularity.
Schneider's letter confirmed the benefits we detailed in our August article mentioned above and in our December interview with the CEO of Prime Care Technologies, a Georgia-based aggregator services company.
©2018 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. firstname.lastname@example.org