Understanding the New CURES Act Regulations for Home Health

Posted on Thursday, January 26, 2017 10:28 PM

Barack Obama signed the 21st Century CURES Act into law, before the end of his second term as President of the United States.

The law contained a few important provisions that will require home health care providers to update or invest in new technology. Additionally, home health agencies with certain services will notice reimbursement changes over the next few years.

The CURES Act will include a new Medicaid requirement for mandatory use of Electronic Visit Verification (EVV). This will allow nurses and home health aides to check in electronically through software apps or devices and record the exact date, time and location of a visit. If an agency fails to implement EVV for personal care and home health care services, agencies and states will face financial penalties.

For personal care services, the act requires that EVV is in place by 2019 and 2023 for home health services.

While many home health care companies already utilize EVV for their care staff as part of their daily routines and practice, there is little consistency across the industry, according to Tom Meyer, former New York State Acting Medicaid Inspector General and current chief program integrity offer of HHAeXchange, a home care software vendor.

“Home care is a vulnerable population,” Meyer told HHCN. “EVV is a great technology for creating a point of control and managing the situation. It’s very good that the [CURES] Act requires it.”

The bill noted the following:
• The government would fund 90% of the costs attributed to the design, development or installation of an EVV system
• The government would fund 75% for the operation and maintenance costs

The funding would go to the states to execute their compliance plans, but Meyer says how states implement the regulation needs more clarity.

“That, we fear, will push states toward more closed systems,” Meyer said.

The following reports are required:
• The Centers for Medicare & Medicaid Services (CMS) will provide a report on the population of Medicare beneficiaries that could benefit most from telehealth services
• The Medicare Payment Advisory Commission (MedPAC) will submit a report on Medicare and private plans that cover telehealth services and Medicare fee-for-service can pay for these services

The Act does not go much further in expanding telehealth, but the National Association for Home Care & Hospice called the roadmap “a good step.”

According to a report from S&P Global Ratings, the provision aims to reimburse at a rate closer to the actual drug prices. This will eliminate or reduce any potential incentive to overprescribe certain drugs based on higher margins.

As of January 1, 2017, the new reimbursement rate went into effect.

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