State delays controversial electronic system mandate for home health care

The state Department of Social Services has agreed to postpone the rollout of a new electronic system for home health agencies after an outcry among providers and threats to drop clients on Medicaid.

Home health agencies were going to be required to begin using the system Feb. 1 to track their workers’ hours and the tasks they perform at each client’s home. Home care agencies that perform non-medical tasks, such as homemaking, have been required to use the system since Jan. 1, and have had many complaints about it.

Under an agreement reached Tuesday afternoon, DSS will push back the date by which home health agencies will be required to begin using the system to April 1. In addition, DSS and caregiver agencies will have “continuing and expanding discussions” about implementing the system. The agreement also calls for implementing the full system without additional extensions or legislation. The date for providers to begin using the system already has been pushed back multiple times.

The agreement was reached between Social Services Commissioner Roderick L. Bremby and Rep. Catherine Abercrombie, the co-chair of the Human Services Committee, after a meeting that also included representatives from Gov. Dannel P. Malloy’s budget office and leaders of the legislature’s appropriations and human services committees. Abercrombie has been pushing DSS for a delay.

The system, known as electronic visit verification, or EVV, is intended to stop fraud or overbilling. DSS expects it will save the Medicaid program between $8 million and $15 million per year.

Home care agency officials say they support the concept, but say the system DSS has required them to use is problematic. Some agencies have had to hire people to manually correct issues with claims so they can be submitted, and some are owed thousands of dollars, they say. Some have indicated they are considering leaving the Medicaid program or no longer accepting new Medicaid clients.

DSS has maintained that the system works, saying that the claims denial rate is lower than in the past and that anecdotes indicate that it is improving services, including by leading workers to arrive at clients’ homes on time.

Abercrombie, D-Meriden, said the agreement gives DSS more time to work with its contractor to address system problems before more agencies require using it. She said she remains concerned about system issues, but said she was thankful there will now be more time to work on them before the medical agencies are required to begin using the system.

The Human Services Committee had been considering raising legislation to delay the rollout, but will not do so as part of the agreement, she said.

The Connecticut Association for Healthcare At Home, which represents home care agencies and has been pushing for the delay, praised the agreement.

“This action indicates that DSS has finally recognized the significance of the outstanding issues still needed to be addressed before full implementation of the EVV in the medical home health provider community,” the association said in a statement. “While we appreciate the 60-day delay, we will continue to ensure that DSS works with the provider community to minimize disruption of care delivery in the home while optimizing home health agency operational efficiencies.”

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