[Congressional Record Volume 164, Number 102 (Tuesday, June 19, 2018)]
[House]
[Pages H5244-H5245]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
DELAYING REDUCTION IN FEDERAL MEDICAL ASSISTANCE PERCENTAGE FOR CERTAIN
MEDICAID PERSONAL CARE SERVICES
Mr. GUTHRIE. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 6042) to amend title XIX of the Social Security Act to delay
the reduction in Federal medical assistance percentage for Medicaid
personal care services furnished without an electronic visit
verification system, and for other purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 6042
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. DELAY IN REDUCTION OF FMAP FOR MEDICAID PERSONAL
CARE SERVICES FURNISHED WITHOUT AN ELECTRONIC
VISIT VERIFICATION SYSTEM.
(a) In General.--Section 1903(l) of the Social Security Act
(42 U.S.C. 1396b(l)) is amended--
(1) in paragraph (1)--
(A) by striking ``January 1, 2019'' and inserting ``January
1, 2020''; and
(B) in subparagraph (A)(i), by striking ``2019 and''; and
(2) in paragraph (4)(A)(i), by striking ``calendar quarters
in 2019'' and inserting ``calendar quarters in 2020''.
(b) Sense of Congress on Stakeholder Input Regarding
Electronic Visit Verification Systems.--It is the sense of
Congress that--
(1) the Centers for Medicare & Medicaid Services should--
(A) convene at least one public meeting in 2018 for the
purpose of soliciting ongoing feedback from Medicaid
stakeholders on guidance issued by the Centers for Medicare &
Medicaid Services on May 16, 2018, regarding electronic visit
verification; and
(B) communicate with such stakeholders regularly and
throughout the implementation process in a clear and
transparent manner to monitor beneficiary protections;
(2) such stakeholders should include State Medicaid
directors, beneficiaries, family caregivers, individuals and
entities who provide personal care services or home health
care services, Medicaid managed care organizations,
electronic visit verification vendors, and other
stakeholders, as determined by the Centers for Medicare &
Medicaid Services; and
(3) taking into account stakeholder input on the
implementation of the electronic visit verification
requirement under the Medicaid program is vital in order to
ensure that the Centers for Medicare & Medicaid Services is
aware and able to mitigate any adverse outcomes with the
implementation of this policy.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Kentucky (Mr. Guthrie) and the gentleman from Massachusetts (Mr.
Kennedy) each will control 20 minutes.
The Chair recognizes the gentleman from Kentucky.
General Leave
Mr. GUTHRIE. Mr. Speaker, I ask unanimous consent that all Members
have 5 legislative days in which to revise and extend their remarks and
insert extraneous materials into the Record on the bill.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Kentucky?
There was no objection.
Mr. GUTHRIE. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, 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 homebound 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 that
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 wastes 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 needed 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
[[Page H5245]]
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.
Thanks to hard work, the bill has changed a little bit working with
Congresswoman DeGette, who came to me and said we want to make sure
that we have stakeholder input. That is included in this version of the
bill that is before us now. Her diligence in doing that has been very
helpful, and I appreciate her efforts in that.
Mr. Speaker, 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.
Mr. Speaker, I reserve the balance of my time.
Mr. KENNEDY. Mr. Speaker, I yield such time as he may consume to the
gentleman from Rhode Island (Mr. Langevin).
Mr. LANGEVIN. Mr. Speaker, I thank the gentleman from Massachusetts
for yielding.
Mr. Speaker, I rise in support of H.R. 6042, which will delay
implementation of the Medicaid electronic visit verification system
requirement by 1 year and promote stakeholder feedback as part of its
implementation.
The Medicaid EVV system requirement under the landmark 21st Century
Cures Act was established to ensure accurate billing and delivery of
personal care services in the homes of Medicaid beneficiaries. We want
to make sure that Medicaid patients are accurately getting the care
that they received, that Medicaid is properly billed for those
services, and that we do everything possible to wring fraud out of the
system.
Unfortunately, the short implementation period, compounded by a delay
in CMS guidance and a lack of stakeholder input, has presented
significant challenges for affected populations, especially seniors and
people with disabilities.
I am pleased to join my colleagues, Representative Guthrie and
Representative DeGette, in supporting this important piece of
legislation. I am glad to see that Representative Guthrie's bill
largely mirrors the bipartisan, bicameral legislation I introduced to
address this issue last month.
The collaboration and the inclusive approach it took to bring this
bill to the floor is the same dynamic Medicaid beneficiaries, family
caregivers, personal care and home health providers, and other
stakeholders are hoping to see from CMS when the agency defines EVV
system requirements so that States can design effective and thoughtful
EVV programs.
Delaying implementation by 1 year and encouraging input from relevant
stakeholders will be paramount to the success of the EVV programs and
is a part of our enduring promise to protect vulnerable populations,
people who would otherwise suffer from adverse outcomes should the
policy be hastily implemented.
Mr. Speaker, I thank Mr. Guthrie, Congresswoman DeGette, Chairman
Walden, Ranking Member Pallone, and all those who had a hand in
bringing this bill to the floor today for the opportunity to join in
leading this important effort.
Mr. KENNEDY. Mr. Speaker, I want to commend the gentleman from Rhode
Island for all of his work and dedication on this issue.
Mr. Speaker, I urge the House to support the bill, and I yield back
the balance of my time.
Mr. GUTHRIE. Mr. Speaker, I yield myself such time as I may consume
to close.
Mr. Speaker, I didn't see my friend from Rhode Island on the floor
when I was speaking earlier on Ms. DeGette and her work in this. He has
been working really hard. I appreciate my friend from Rhode Island
leading on this issue and us being able to work together and our staffs
working together to make something very important like this. His input
was very important on the stakeholder issue, as was Ms. DeGette's.
Mr. Speaker, I urge my colleagues to vote for the bill, and I yield
back the balance of my time.
Ms. DeGETTE. Mr. Speaker, I would like to thank Representatives
Guthrie and Langevin for working with me on this very important bill,
which addresses a national health care issue involving safety,
efficiency and privacy affecting many of our constituents.
As most people who have been engaged in this matter know, the mental
health portion of the 21st Century Cures Act--the overwhelmingly
bipartisan biomedical reform bill that was signed into law in December
2016--included what is called electronic visit verification (EVV)
provisions. These provisions require states to verify the provider,
date, time and site of personal care and home health services.
They were meant to give patients the power to hold their providers
accountable for delivering services when and where they are supposed to
do so.
But given the delay by the Centers for Medicare and Medicaid Services
(CMS) in getting guidance for implementation of the provisions to the
states, and the way the agency ignored Congressional intent to involve
stakeholders in the regulatory process, House members had to step in to
try and right what the Executive Branch has done poorly in the past
year and a half.
The bill before you today grants a one-year delay in implementation
of the EVV requirements. It also requires CMS to involve stakeholders
both in the planning and throughout the implementation of the EVV
requirements to ensure that the privacy and civil rights of consumers
are protected.
This bill ensures that administrative and financial burdens on
service providers are neither onerous nor duplicative and that states
are able to design and implement their EVV programs in a thoughtful,
deliberative manner. It also affords CMS the opportunity to hear from
beneficiaries enrolled in self-directed plans about the challenges EVV
could present for them.
This legislation will also help foster a comprehensive and
transparent process that carefully balances the serious privacy
concerns of consumers and caregivers, the administrative and financial
concerns of providers and states, and EVV's goals of patient control
and fraud prevention.
Mr. Speaker, if properly implemented EVV has potential to ensure that
high-quality services are delivered when and where needed, while also
reducing the potential for waste and fraud. This legislation will
require CMS to follow a proper stakeholder engagement process, in order
to ensure that the policy is implemented correctly. It will also allow
each state greater opportunity to ensure that its EVV programs are best
suited to individuals' specific needs.
I strongly urge all members to support this bill.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Kentucky (Mr. Guthrie) that the House suspend the rules
and pass the bill, H.R. 6042, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
A motion to reconsider was laid on the table.
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