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ICYMI: Guthrie Bill to Target Fraud, Modernize Medicaid Passes House

WASHINGTON, D.C.– Congressman Brett Guthrie’s (KY-02) bill to modernize state Medicaid programs and help those who rely on in-home health services get quality care (H.R. 6042) yesterday passed the U.S. House of Representatives unanimously.

Many of the most vulnerable Medicaid patients rely on in-home visits for delivery of their health care services, including the disabled and the elderly who cannot as easily leave their home to access services. Electronic visit verification (EVV) systems allow states to keep better track of these critical in-home visits for Medicaid patients. The Guthrie bill would ensure the proper implementation of EVV systems in state Medicaid programs. After learning from the Department of Health and Human Services (HHS) Office of Inspector General that many of the state in-home visit programs were wasting taxpayer money and endangering vulnerable patients, Guthrie in 2016 worked to include language in the  21st Century Cures Act that would require each state Medicaid program to adopt EVV systems.

As the 21st Century Cures Act has been implemented, state Medicaid programs and stakeholders have indicated that more time is needed to properly incorporate EVV technology into state Medicaid systems. Congressman Guthrie introduced H.R. 6042 to allow states more time to implement EVV systems – ensuring that legislation intended to protect patients who rely on Medicaid in-home services and prevent fraud and abuse in the program will be effective, rather than simply generating additional layers of government bureaucracy.

“EVV provides a way to track the delivery of in-home Medicaid personal care services to help prevent instances of fraud and abuse and to protect patients, ensuring they get the services they are entitled to receive,” said Guthrie in a speech on the House floor this afternoon. “Home visits are a critical part of providing quality care to patients, many of whom have disabilities and rely on extra care in their homes. H.R. 6042 will make sure that EVV can be implemented effectively.”

The full text of Congressman Guthrie’s floor speechas prepared is included below:

“I rise today in support of my bill, H.R. 6042, which will ensure the proper implementation of the electronic visit verification system, or EVV, in state Medicaid programs. EVV provides a way to track the delivery of in-home Medicaid personal care services to help prevent instances of fraud and abuse and to protect patients, ensuring they get the services they are entitled to receive.

“Many frail, disabled, or otherwise home-bound patients benefit from and even rely on Medicaid personal care services and home health services. Yet, the Department of Health and Human Services Office of Inspector General (OIG) found in recent years that the existing program safeguards at the time were often ineffective, despite the fact they were intended to prevent improper payments and to ensure medical necessity, patient safety, and quality care. Furthermore, the OIG warned that fraud in this area was on the rise – which endangers vulnerable patients and waste taxpayer money. EVV systems were developed to protect some of the most vulnerable Medicaid recipients.

“Last Congress, in response to the OIG report, I wrote and included a provision in the bipartisan 21st Century Cures Act to require state Medicaid programs to use EVV to track all personal care services conducted in a patient’s home. In the time since the implementation of Cures, I have received feedback that more time is need to implement EVV systems to make sure that they are properly and fully integrating the EVV technology.

“This year I worked with Congresswoman DeGette and Congressman Langevin to introduce H.R. 6042, which gives states an extra year to put in place their EVV systems and ensure stakeholder input. Home visits are a critical part of providing quality care to patients, many of whom have disabilities and rely on extra care in their homes. H.R. 6042 will make sure that EVV can be implemented effectively.

“I urge my colleagues to support this bipartisan bill to provide a simple fix for the benefit of improved accountability and patient care in state Medicaid programs.”

 

 

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