VERIFI Act

Summary: Verifying Electronically the Receipt of In-Home Care For Individuals Act or the VERIFI Act This bill amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to require the use of electronic visit verification systems for certain services under the Medicare and Medicaid programs. An "electronic visit verification system" is a system under which care-related visits are electronically verified with regard to: (1) the type and date of service, (2) the individual receiving the service, (3) the individual providing the service, (4) the location of service delivery, and (5) the time the service begins and ends. With respect to the Medicare program,&nbsp;a home health agency must have such a system in place&nbsp;for home health services as a condition of participation. In the case of a state Medicaid program that does not require the use of such a system for both personal care services and home health services, the federal medical assistance percentage for medical assistance expended on such services shall be reduced beginning in 2019. These reductions increase incrementally from 0.25% to 1.00% through 2023. With respect to the Medicare program, the Centers for Medicare &amp; Medicaid Services shall establish standards for the systems and must consult with agencies to ensure that such standards: (1) are minimally burdensome, (2) account for existing best practices and electronic visit verifications systems already in use, and (3) require that the systems are conducted in accordance with specified legal requirements related to privacy and security.&nbsp;In regard to&nbsp;a state Medicaid program, a state shall do the same.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Verifying Electronically the Receipt 
of In-Home Care For Individuals Act'' or the ``VERIFI Act''.

SEC. 2. REQUIREMENT THAT MEDICARE HOME HEALTH AGENCIES HAVE IN PLACE AN 
              ELECTRONIC VISIT VERIFICATION SYSTEM.

    (a) Condition of Participation.--Section 1891(a) of the Social 
Security Act (42 U.S.C. 1395bbb(a)) is amended by adding at the end the 
following new paragraph:
            ``(7)(A) In the case of home health services furnished on 
        or after January 1, 2018, the agency has in place an electronic 
        visit verification system that meets standards established by 
        the Secretary.
            ``(B) In this paragraph, the term `electronic visit 
        verification system' means a system under which visits 
        conducted as part of home health services furnished by a home 
        health agency are electronically verified by the agency with 
        respect to--
                    ``(i) the type of service performed;
                    ``(ii) the individual receiving the service;
                    ``(iii) the date of the service;
                    ``(iv) the location of the service is furnished;
                    ``(v) the individual furnishing the service; and
                    ``(vi) the time the service begins and ends.
            ``(C) By not later than July 1, 2017, the Secretary shall 
        establish standards for electronic visit verification systems. 
        In establishing such standards, the Secretary shall consult 
        with home health agencies to ensure that such standards--
                    ``(i) are minimally burdensome;
                    ``(ii) take into account existing best practices 
                and electronic visit verification systems in use; and
                    ``(iii) require that the systems are conducted in 
                accordance with the requirements of HIPAA privacy and 
                security law (as defined in section 3009 of the Public 
                Health Service Act).''.
    (b) Rules of Construction.--
            (1) No employer-employee relationship established.--Nothing 
        in the amendment made by this section may be construed as 
        establishing an employer-employee relationship between the home 
        health agency and the individuals who, under a contract with 
        such an agency, furnish such services for purposes of part 552 
        of title 29, Code of Federal Regulations (or any successor 
        regulations).
            (2) No particular or uniform electronic visit verification 
        system required.--Nothing in the amendment made by this section 
        shall be construed to require the use of a particular or 
        uniform electronic visit verification system (as defined in 
        paragraph (7)(B) of section 1891(a) of the Social Security Act 
        (42 U.S.C. 1395bbb(a)), as added by subsection (a)) by all 
        agencies that furnish home health services under title XVIII of 
        such Act.
            (3) No limits on provision of care.--Nothing in the 
        amendment made by this section may be construed to limit, with 
        respect to home health services furnished under title XVIII of 
        the Social Security Act, provider selection, constrain 
        beneficiaries' selection of a caregiver, or impede the manner 
        in which care is furnished.

SEC. 3. ELECTRONIC VISIT VERIFICATION SYSTEM REQUIRED FOR PERSONAL CARE 
              SERVICES AND HOME HEALTH CARE SERVICES UNDER MEDICAID.

    (a) In General.--Section 1903 of the Social Security Act (42 U.S.C. 
1396b) is amended by inserting after subsection (k) the following new 
subsection:
    ``(l)(1) Subject to paragraph (3), with respect to any amount 
expended for medical assistance for personal care services or home 
health care services provided under a State plan under this title (or 
under a waiver of the plan) furnished in a calendar quarter beginning 
on or after January 1, 2019, unless a State requires the use of an 
electronic visit verification system for both personal care services 
and home health care services furnished in such quarter under the plan 
or such waiver, the Federal medical assistance percentage shall be 
reduced--
            ``(A) for calendar quarters in 2019 and 2020, by .25 
        percentage points;
            ``(B) for calendar quarters in 2021, by .5 percentage 
        points;
            ``(C) for calendar quarters in 2022, by .75 percentage 
        points; and
            ``(D) for calendar quarters in 2023 and each year 
        thereafter, by 1 percentage point.
    ``(2) Subject to paragraph (3), in implementing the requirement for 
the use of an electronic visit verification system under paragraph (1), 
a State shall consult with agencies and entities that provide personal 
care services, home health care services, or both under the State plan 
(or under a waiver of the plan) to ensure that such system--
            ``(A) is minimally burdensome;
            ``(B) takes into account existing best practices and 
        electronic visit verification systems in use in the State; and
            ``(C) is conducted in accordance with the requirements of 
        HIPAA privacy and security law (as defined in section 3009 of 
        the Public Health Service Act).
    ``(3) Paragraphs (1) and (2) shall not apply in the case of a State 
that, as of the date of the enactment of this subsection, requires the 
use of any system for the electronic verification of visits conducted 
as part of both personal care services or home health care services.
    ``(4) In this subsection:
            ``(A) The term `electronic visit verification system' 
        means, with respect to personal care services or home health 
        care services, a system under which visits conducted as part of 
        such services are electronically verified with respect to--
                    ``(i) the type of service performed;
                    ``(ii) the individual receiving the service;
                    ``(iii) the date of the service;
                    ``(iv) the location of service delivery;
                    ``(v) the individual providing the service; and
                    ``(vi) the time the service begins and ends.
            ``(B) The term `home health care services' means services 
        described in section 1905(a)(7) provided under a State plan 
        under this title (or under a waiver of the plan).
            ``(C) The term `personal care services' means personal care 
        services provided under a State plan under this title (or under 
        a waiver of the plan), including services provided under 
        section 1905(a)(24), 1915(c), 1915(i), 1915(j), or 1915(k) or 
        under a waiver under section 1115.''.
    (b) Rules of Construction.--
            (1) No employer-employee relationship established.--Nothing 
        in the amendment made by this section may be construed as 
        establishing an employer-employee relationship between the 
        agency or entity that provides for personal care services or 
        home health care services and the individuals who, under a 
        contract with such an agency or entity, furnish such services 
        for purposes of part 552 of title 29, Code of Federal 
        Regulations (or any successor regulations).
            (2) No particular or uniform electronic visit verification 
        system required.--Nothing in the amendment made by this section 
        shall be construed to require the use of a particular or 
        uniform electronic visit verification system (as defined in 
        subsection (l)(4) of section 1903 of the Social Security Act 
        (42 U.S.C. 1396b), as inserted by subsection (a)) by all 
        agencies or entities that provide personal care services or 
        home health care services under a State plan under title XIX of 
        the Social Security Act (or under a waiver of the plan).
            (3) No limits on provision of care.--Nothing in the 
        amendment made by this section may be construed to limit, with 
        respect to personal care services or home health care services 
        provided under a State plan under title XIX of the Social 
        Security Act (or under a waiver of the plan), provider 
        selection, constrain beneficiaries' selection of a caregiver, 
        or impede the manner in which care is delivered.