Providers Dispute Connecticut Electronic Verification System

HARTFORD (CN) – Companies that hire home care workers in Connecticut claim in court that the state’s implementation of a telephonic and computer-based in-home scheduling, tracking and billing system threatens their businesses.

Six home care providers with more than 3,500 employees who provide services to about the same number of residents claim in a lawsuit filed last week that the Connecticut Department of Social Services, the agency responsible for the Medicaid program, has failed to implement internal controls by outsourcing the electronic visit verification system to a third party.

Nonparties Hewlett Packard Enterprise and Sandata Technologies LLC hold the contract with the state to handle the verification system.

According to the complaint filed Nov. 16 in Hartford Superior Court, the companies were paid more than $1.7 million to develop and implement the system for Connecticut.

The plaintiffs employ personal care attendants, or PCA’s, who provide basic services such as assistance with bathing, dressing, toileting, housecleaning, and cooking to Medicaid recipients in their homes.

The new system will require the PCA’s to use a telephone to log their precise time of arrival and the care provided. The department is requiring the new system to be used starting Dec. 1.

According to the 10-page complaint, the codes and payment information entered by PCA’s would bypass the providers and make them “wholly dependent upon a DSS vendor the employer did not select that is not contractually bound to the employer, for all the data the employer needs to prepare payroll, submit billing and reimbursement requests, and provide time and task records for use in Medicaid audits.”

The plaintiffs also object to a requirement that their employees enter the last five digits of their Social Security number into the system.

“Plaintiffs have confirmed that employee identification is not secure if employers disclose the final five numbers of employee SSNs,” the complaint states.

Without commenting on the lawsuit, DSS said it has begun electronic verification on a voluntary basis with over 100 home care and home health providers, and is planning to gradually expand it statewide.

“The overall result will be improved accuracy in claims and payments – and this will benefit consumers, providers and taxpayers alike,” David Dearborn, a DSS spokesman, said Friday. “Annual savings of $8 million to $15 million in Medicaid are estimated from this measure to improve system accuracy.”

A spokeswoman from the Connecticut Attorney General’s Office said they will review the complaint and respond at the appropriate time in court.

The plaintiffs are Companions and Homemakers Inc.; Caring Solutions LLC; M.R. Home Care Inc.; Quality Home Care LLC; A&B Employer Solutions LLC; and Angel Touch Care LLC.

They complain that DSS has told them if the new system isn’t used after Dec. 1, “no payment for services will be authorized.”

Without payment, the plaintiffs say they would not be able to fulfill their commitment to the more than 3,600 recipients of their services.

The providers are seeking a declaratory judgment from the court because they don’t have 90 days to challenge DSS through the agency’s administrative process.

They are also asking for an injunction, claiming their clients will be harmed because they are unable to meet the Dec. 1 deadline.

The plaintiffs are represented by William Sweeney Jr. of New Britain, Conn.

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