Medicaid Update: Updated FMAP reduction figures

 

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EVV Update: Deadline to Implement EVV for Personal Care Services Delayed until 2020

On July 30, 2018, legislation was passed to amend Section 1903(l) of the Social Security Act to delay the timeline for states to implement electronic visit verification (EVV) for personal care services by one year. The legislation does not affect timelines for home health care services. Previously, states were required to implement EVV for personal care services by January 1, 2019, or otherwise be subject to Federal Medical Assistance Percentage (FMAP) reductions as follows:

  • .25 percentage points for calendar quarters in 2019,
  • .25 percentage points for calendar quarters in 2020
  • .5 percentage points for calendar quarters in 2021
  • .75 percentage points for calendar quarters in 2022
  • 1 percentage point for calendar quarters in 2023 and each year thereafter

Under the new timeline, states are required to implement EVV for personal care services by January 1, 2020, or otherwise be subject to FMAP reductions as follows:

  • .25 percentage points for calendar quarters in 2020,
  • .5 percentage points for calendar quarters in 2021
  • .75 percentage points for calendar quarters in 2022,
  • 1 percentage point for calendar quarters in 2023 and each year thereafter

States that have not implemented EVV by January 1, 2020 will be subject to FMAP reductions unless they have both made a “good faith effort” to comply and have encountered “unavoidable system delays.”  States with good faith effort exemptions will not be subject to FMAP reductions in 2020, however will be subject to incremental FMAP reductions beginning with 0.5 percentage points for calendar quarters in 2021 if they have not implemented an EVV system by January 1, 2021. Please be advised that the provision on good faith effort exemptions does not provide CMS with authority to delay the FMAP reductions for more than one year.

CMS had previously indicated that it would accept requests for good faith efforts starting in July, 2018. However given the passage of this legislation, requests should be submitted to CMS in July, 2019. Please contact the CMS EVV mailbox at EVV@cms.hhs.gov for questions or concerns.

Please be advised that EVV resources published on Medicaid.gov prior to July 30, 2018 may reference dates that are impacted by this change.