DELAYING REDUCTION IN FEDERAL MEDICAL ASSISTANCE PERCENTAGE FOR CERTAIN MEDICAID PERSONAL CARE SERVICES; Congressional Record Vol. 164, No. 102
(House of Representatives - June 19, 2018)

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[Pages H5244-H5245]
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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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