Case Study
The Practice
Compliance Auditing
The Client
State Agency
The Challenge
The 21st Century Cures Act mandates that states implement Electronic Visit Verification (EVV) for all Medicaid personal care services (PCS) and home health services (HHCS) that require an in-home visit by a provider. Failure to comply will subject the state to incremental Federal Medical Assistance Percentage (FMAP) reductions if not implemented.
The Solution
Garnet Rivers Compliance Review Team (CRT) will conduct compliance outreach and reviews to cover EVV attestation and EVV data submission requirements. For providers who are found to be noncompliant, the CRT will perform outreach and compliance reviews of providers encounter claims and data to work with those providers to identify discrepancies in their EVV data submissions practices.
The Impact
By remaining compliant with federal regulations and mandates ensures states will not lose federal assistance dollars and will improve the health and welfare of individuals through validation of delivery of services all while generating a cost savings from the prevention of fraud, waste, and abuse.
