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Capitol Correspondence - 07.30.18

CMS Answers ANCOR’s Letter of Concern on EVV Implementation

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Last week, ANCOR received a response from the Centers for Medicare and Medicaid Services (CMS) regarding our May 22nd letter sharing I/DD providers’ concerns on Electronic Visit Verification (EVV) implementation. ANCOR’s letter focused on I/DD supports and services, bringing up questions surrounding the implementation timeframe, the scope of the CMS’s implementation efforts, privacy concerns and lack of stakeholder input.

While Congress has since addressed our concerns about the timeframe by passing a bill delaying the implementation of the EVV statute by one year, the policy and implementation questions raised in ANCOR’s letter remain. These issues fall within CMS’ jurisdiction.

Concerning the scope of programs the EVV statute covers, the ANCOR letter stated: “We are concerned that our programs, the majority that are served under the 1915(c) model, will be wrapped into the EVV compliance requirements despite not having been the intended congressional target.”

The CMS response reads: “While CMS acknowledges these concerns, the Cures Act specifies the Medicaid authorities to which EVV requirements apply and does not grant CMS the flexibility to exempt certain populations within those authorities.”

Regarding privacy, ANCOR’s letter stated: “The individuals served by our members are primarily people with significant disabilities that require supports throughout their lifespan. It would be an inappropriate use of federal authority to require tracking of their daily interactions in exchange for these supports. […] ANCOR strongly believes privacy concerns need to be dealt with by CMS and guidance carefully structured before states are asked to implement their own systems.” The emphasis is in the original letter.

The CMS letter responds thusly to this concern: “Regarding privacy, CMS will consider this as a topic for future trainings and guidance to help ensure states’ EVV systems are responsive to stakeholder concerns.”

Finally, on the topic of stakeholder input, ANCOR wrote: “The legislation itself requires states to take into account a stakeholder process with input from beneficiaries, family caregivers, individuals who furnish personal care services or home health services, and other stakeholders as determined by the State in accordance with guidance from the Secretary. However, the guidance and timeframe left for implementation do not provide the foundation for meaningful public input.”

The CMS addressed this topic in the following manner: “EVV implementation requirements and timelines under the Cures Act did not mandate a formal input process such as developing a Notice of Proposed Rulemaking, requesting formal public comment, and developing a Final Rule. However, CMS has welcomed and continues to receive stakeholder input through other avenues and makes every effort to incorporate that feedback into guidance for states, beneficiaries, your members and other providers where possible.”

ANCOR staff is already working with our external lobbyists to work with key Hill officials and CMS to address the response the agency had, given our continued overarching concerns. We will continue to keep members informed of developments and opportunities for advocacy on this topic.