Sending Office: Honorable James R. Langevin
Sent By:

        Request for Cosponsor(s)

Dear Colleague:

Serious concerns have been raised about the interpretation and implementation of the Medicaid Electronic Visit Verification (EVV) provisions included in the 21st Century Cures Act (P.L. 114-255).  The EVV system requires healthcare providers and patients
to use electronic methods to confirm accurate billing and delivery of personal care services in the home of Medicaid beneficiaries. However, the short implementation period and delay in issuing CMS guidance have presented significant challenges in achieving
an effective roll out. 

Despite the guidance provided on May 16, 2018, there are several issues relating to EVV that lack of clarity. For example, the CMS guidance doesn’t address whether EVV must only cover personal care services and home health services provided in a person’s
own home or include additional settings like work, school, or other licensed residential settings. Other basic questions remain, including about how EVV requirements apply when services are provided in multiple locations during a shift. 

There are also privacy concerns as EVV systems track the location of consumers and their caregivers engaging in everyday activities throughout the community, like grocery shopping, running errands, and participating in recreational activities. Notably, CMS
did address some concerns about self-directed services in its guidance, but there are still gaps that should be addressed with stakeholder input.

H.R. 5912, provides a one-year delay for EVV implementation combined with notice and comment rulemaking in order to ensure that the privacy and civil rights of consumers
are protected; that the administrative and financial burdens on service providers are neither onerous nor duplicative; and that states can design and implement their EVV programs in a thoughtful, deliberative manner.

A delay would allow states to:  

  • work with CMS to resolve questions about EVV implementation and negotiate any necessary approvals to their Medicaid plans and waivers;
  • work with their state legislatures to secure funding for the costs not covered by the federal match;
  • allow for adequate participation by stakeholder groups as required by 21st Century Cures;
  • ensure that all consumers and direct support professionals understand how to use the EVV system;
  • design pilot programs and/or phased roll-outs of implementation; and
  • assure that important education on fraud prevention is included in training and education.

The current implementation date of January 1, 2019, for personal care services is too ambitious. Our bill seeks to delay this implementation date by one year in order to provide time for added clarity so that affected populations – especially seniors and
people with disabilities – may also have the opportunity to share feedback as part of a formal rulemaking process.

Groups that support a delay of EVV include the Center for Public Representation; Autistic Self-Advocacy Network; The Arc of the United States; American Network of Community Options & Resources (ANCOR); Bazelon Center for Mental Health Law; National Disability
Rights Network; and The Consortium for Citizens with Disabilities (CCD).

We hope you can join us in this effort. If you have any questions, or would like to cosponsor this bill, please contact Elyssa Malin (Langevin) at


Jim Langevin

Member of Congress

Diana DeGette

Member of Congress

Don Young

Member of Congress

Steve Stivers

Member of Congress

Related Legislative Issues

Selected legislative information: Family Issues, Government, HealthCare

Related Bill Information

Bill Type: H.R.
Bill Type: 5912
Special Note:

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