Essentially, the CURES Act was passed in late December 2016 to do a number of things, one of which was to help cut down on Medicaid fraud in the home health industry. Under this new regulation, every state across the U.S. must ensure that home care agencies providing Medicaid services and seeking Medicaid reimbursement are using an approved Electronic Visit Verification (EVV) system to accurately track and record caregiver services provided to clients. The first requirements, effective Jan. 1, 2019, will apply just to personal care services covered by Medicaid, while the home health services sector covered by Medicaid will have until Jan. 1, 2023.
States are allowed to independently determine the specifics around what EVV systems they will accept as approved systems in their own states. A variety of models to this are being used. For example, several states are using a “closed” model where agencies will be required to use a system of the state’s choosing. Other states are using an “open” model where agencies can use the vendor of their choice as long as it meets certain federal requirements.
If a state fails to comply with the new requirements set forth by the CURES Act regarding use of an EVV system, that state will be penalized by losing a percentage of its Medicaid funding that is provided by the federal government.
An example of an approved, fully-compliant wireless application is Tellus. Tellus is a leading U.S. provider of mobile Electronic Visit Verification and claims processing technology designed especially for the Home Health and Long-Term Care markets. Tellus is proud to be the provider of choice among a variety of national, state and local agencies. The company’s comprehensive, cloud-based solutions work to simplify, streamline and quickly and easily verify care delivery tasks and process claim data right at the point of care.
This enables health care agencies, caregivers and patients to focus their efforts on what matters most — improved patient care and better outcomes, operational efficiency and cost reduction. Working together, Sprint and Tellus will focus on helping states comply with the 21st Century Cures Act expanding on technologies users are already familiar with. These will tie sophisticated backend processes, transitioning historically cumbersome manual practices to a streamlined system of automation. While Tellus has signed an exclusive arrangement with Sprint to provide this solution, Tellus is carrier agnostic. The application for the end-user is simple: Caregivers simply check in when they arrive, check off care tasks as they’re delivered and check out when the visit is complete.
For more information, please contact Alissa Gedman at Alissa.Gedman@Sprint.com.