Michigan Medicaid and EVV (Electronic Visit Verification)

Michigan EVV MedicaidWhat’s happening with Michigan EVV?

Currently in Michigan there is no action required at this time if you are a Medicaid provider and it does say that the timeline for when EVV (Electronic Visit Verification) will me rolled out in Michigan has not been determined yet but it is coming!

What can this mean for you if you are Medicaid provider in Michigan?

How any given State choses to handle this has been different in every state that we have been involved with. There is no reason to believe that this will be different in Michigan. That means that a slightly different way of rolling out EVV in Michigan will be what we expect. We can narrow it down to some possibilites knowing that Michigan will most likely tweak some variety of the scenarios laid out below.  exactly the same as any given state but here are some scenarios that we have seen with some of the pros and cons of the process.

Here are some scenarios for what you might expect to happen with Michigan Medicaid and the EVV mandate

  1. The State chooses an an open model where an aggregator works with an existing EVV system such and Rosemark. This means that a company like Rosemark that will send data from a given agency through the aggregator like Tellus, HHAeXchange, Sandata or others, to the State. This insures the agency of getting paid by the State
  2. The State may decide to use different aggregators for different programs and with any given MCO (Managed Care Organization). See the list of Michigan Medicaid programs that might be impacted if this is the path that is chosen by the State.
  3. Michigan may decide to choose a single provider for their EVV service.  In this case the providers would be required to choose this EVV company for becoming EVV compliant. Using a company like Rosemark would still enable you to handle your scheduling and payroll to manage your agency.
  4. The State Medicaid Program also has the option to let home care providers to use any EVV vendor as long as the data is received by the state in the correct format.
  5. Michigan may also decide not to comply with the 21st century Cures Act EVV mandate and inccur fines to that effect. This may require that the state pass on these addtional expences to the providers or they may have less funding to offer to Michigan home health care providers.

The 21st Century Cures Act, the Centers for Medicare & Medicaid Services (CMS) requires that States implement an Electronic Visit Verification (EVV) system. See below the descriptions of Michigan Medicaid EVV impact on different populations, programs.

“The Michigan Department of Health and Human Services submitted an Electronic Visit Verification (EVV) Good Faith Effort exemption request to CMS, requesting a delay in the implementation of EVV for Personal Care services. On December 23, 2019, CMS granted the exemption request, delaying the implementation of EVV for Personal Care services until January 1, 2021.  Implementation of EVV for Home Health Care services is not impacted by this exemption. EVV for Home Health Care services is to begin January 1, 2023.”  It is still unknown how the State of Michigan plans to proceed since an implementation plan has not been decided as of January, 2021.

MDHHS continues to urge caregivers, providers, and beneficiaries that no action is required at this time. Please continue to check this website frequently for updates and changes.

Impacted Michigan Medicaid Programs

According to the Michigan Medicaid Website, these programs might be affected by the EVV mandates in the future:

“Beneficiaries, clients, participants, caregivers or providers in one of the following Medicaid programs or benefit plans will be impacted by EVV. Click on the program name to learn more about the services offered:

  • Home Help – Provides personal care services to individuals who need hands-on assistance with Activities of Daily Living (ADLs) and assistance with Instrumental Activities of Daily Living (IADLs).
  • Home Health Services – A covered benefit for beneficiaries with conditions not requiring continuous medical/nursing and related care but do require health services on an intermittent basis in the home setting for the treatment of an injury, illness, or disability.
  • Children’s Waiver Program * – The Children’s Waiver Program (CWP) is a federal entitlement program that provides Medicaid funded home and community-based services to children (under age 18).​
  • Habilitation Supports Waiver * – Beneficiaries with developmental disabilities may be enrolled in this Program to receive the supports and services as defined. HSW beneficiaries may also receive other Medicaid State plan or additional/B3 services.​​​​​​
  • Children with Serious Emotional Disturbances Waiver * – The Children’s Serious Emotional Disturbance Waiver (SEDW) provides Services that are enhancements or additions to Medicaid State Plan coverage for children up through age 18 with serious emotional disturbance, who are enrolled in the SEDW.​​​
  • MI Choice Waiver – Eligible adults who meet income and asset criteria can receive Medicaid-covered services like those provided by nursing homes but can stay in their own home or another residential setting.​​
  • MI Health Link – A single program for qualifying individuals who are eligible for both Medicare and Medicaid. MI Health Link offers a broad range of services including medical, behavioral health, pharmacy, nursing home care, and home and community-based services.​​​”

To learn more about Rosemark’s mobile visit verification system and our entire suite of cloud-based software systems, reach out to us today at (734) 662-3537. We’d love the opportunity to schedule a no-obligation demonstration and answer any questions you have about our industry-leading software solutions.

The makers of the Rosemark System, Shoshana Technologies, is proud to be Michigan Company. Let’s celebrate Michigan together!

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