Complex Care Committee hears about serious problems with new technology for home health visits

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Friday’s meeting of MAPOC’s Complex Care Committee focused on problems with DSS’s new Electronic Verification System to ensure accountability in provision of home care to Medicaid members. Implementation of the troubled, costly, mandated system began January 1st and is scheduled to be completed February 1st. All stakeholders, including consumer advocates and home health agencies, repeated their strong commitment to program integrity. However because of significant problems with the new system, agencies have not been able to submit visits and claims to the system and have not been paid, and have had to hire more administrative staff, with no compensation for the increased burden. Concerns were raised that, contrary to federal regulations and laws, the system was not developed in collaboration with stakeholders, providers cannot bill for care provided in the community, and that flaws in the system violate patient privacy rights. Agencies, advocates and legislators have called on DSS to halt implementation of the new system until problems can be corrected. The Complex Care Committee asked DSS to provide a response to concerns raised in the meeting, ongoing reports tracking access to care, utilization, and payments to providers, as well as a corrective action plan. Legislators and DSS are meeting today to discuss the issue.