Fiscal impact reports (FIRs) are prepared by the Legislative Finance Committee (LFC) for standing finance
committees of the Legislature. LFC does not assume responsibility for the accuracy of these reports if they
are used for other purposes.
F I S C A L I M P A C T R E P O R T
SPONSOR Armstrong
LAST UPDATED
ORIGINAL DATE 2/14/2024
SHORT TITLE Health Care Authority Visit Verification
BILL
NUMBER House Bill 269/ec
ANALYST Chenier
ESTIMATED ADDITIONAL OPERATING BUDGET IMPACT*
(dollars in thousands)
Agency/Program
FY25 FY26 FY27
3 Year
Total Cost
Recurring or
Nonrecurring
Fund
Affected
Aggregator
implementation
$160.0 $160.0 Nonrecurring General Fund
EVV
Implementation
$85.0 $85.0 Nonrecurring General Fund
EVV O&M $641.7 $58.3 $700.0 Recurring General Fund
Aggregator O&M $60.0 $360.0 $30.0 $450.0 Re curring General Fund
2 HCA Staff $107.8 $107.8 $215.6 Recurring General Fund
2 HCA Staff $107.8 $107.8 $215.6 Recurring Federal Funds
Total $305.0 $1,217.3 $30 3.9 $1,826.2
Parentheses ( ) indicate expenditure decreases.
*Amounts reflect most recent analysis of this legislation.
Sources of Information
LFC Files
Agency Analysis Received From
Health Care Authority (HCA)
SUMMARY
Synopsis of House Bill 269
House Bill 269 requires the Health Care Authority (HCA) to implement an open (aggregator)
electronic visit verification system (EVV) that is compliant with federal law. This bill declares
an emergency. EVV is a system that allows the authority to ensure that provider visits (usually to
the home) actually take place.
This bill contains an emergency clause and would become effective immediately on signature by
the governor.
FISCAL IMPLICATIONS
HCA states that providers have been working with HCA to move from a closed EVV solution to
an open EVV solution that will meet federal requirements and will allow providers to select their
own EVV vendor. HCA will need to contract with a vendor that will implement an aggregator House Bill 269/ec – Page 2
module to allow EVV vendors to aggregate provider data to the EVV solution. HCA will use the
aggregated data to report federally required information to the federal Centers for Medicare and
Medicaid Services. The estimated implementation cost of an aggregator is $160 thousand with
ongoing operational costs of $30 thousand per month.
HCA staff would dedicate resources to update the New Mexico Administrative Code and other
documentation; conduct system testing and edit current claims processing systems; and provide
training and communications to incorporate an aggregator model.
The oversight and ongoing monitoring to ensure compliance with the bill would require two (2)
new employees at a cost $215.6 thousand: $107.8 from the general fund and $107.800 in federal
matching funds.
SIGNIFICANT ISSUES
HCA said that electronic visit verification (EVV) has been required of certain providers since
2016 in accordance with the federal 21st Century Cures Act. New Mexico is currently a closed
system, meaning the current vendor is the sole EVV intake vendor. Most states are “open” which
allows EVV aggregators to ingest EVV data from users to pass on to an EVV vendor. HCA is
actively planning incorporation of an EVV aggregator based on provider input. HCA believes
that resources can be dedicated as early as May 2025 with an estimated project completion date
of July 2025.
Enacting HB269 may reduce costs and administrative burden for providers of personal care
service and home health services.
Providers report signification challenges with integrating provider electronic medical records
(EMR) platforms and need to work in multiple systems for each personal care and home health
visit.
Medicaid-reimbursed home healthcare and personal care service providers currently utilize an
electronic visit verification (EVV) system that complies with and collects required information
under the federal 21st Century Cures Act.
EC/hj/hg