Who bears the cost of compliance with state-specific operational and technology requirements for Brightstar Care's Medicaid participation?
Brightstar_Care Franchise · 2025 FDDAnswer from 2025 FDD Document
ched as Exhibit M.
NOTE 5: Electronic Visit Verification ("EVV") is required by some states when a franchisee participates in certain Medicaid waiver programs. If required by the state, this fee covers the cost of integrating ABS with the state aggregators or third party/ies selected by the state. If any fees are charged to use a state-specified EVV system, that cost is your responsibility. The integration enables the data required to authorize and approve payment to flow automatically between ABS and the state. Without this automation, the state may require the franchisee to enter the data manually on its portal or website. The one-time fee per aggregator covers the initial set-up and testing of the integration. Most states require integration with only one aggregator, while other states might require integration with up to 2 aggregators. The on-going "per record" charge covers the ongoing maintenance costs of supporting the integration and on-going changes required by the state. It is your responsibility to understand your state's EVV requirements and notify us with sufficient lead time to integrate into ABS. You must notify BrightStar Technology no less than 90 days before the state's implementation date, or any subsequent EVV version upgrade dates, to allow sufficient time for integrating ABS and/or updating ABS with EVV version upgrades.
If you notify BrightStar Technology less than 90 days before either your state's implementation date or your state's subsequent EVV version upgrade implementation dates, BrightStar Technology may charge you up to an additional $1,000 for the initial integration, and up to an additional $500 for any subsequent EVV version upgrade, required by the state.
You have the option of using another state EVV provider whom we approve; however, you still must pay us the $1,000 integration fee per aggregator and $500 for each EVV version upgrade required by the state. All other fees required by the third-party provider would be paid directly by you to the third-party provider.
NOTE 6. Insurance Policies. We identify the types and minimum insurance coverage you must carry in our Operations Manual. You must obtain insurance coverage only from the agencies and carriers we designate. We make no representation that the coverage will be sufficient for your business purposes. You need to evaluate if your business will require broader coverage, higher limits, or additional types of insurance also available through the approved agency. Some of these insurance policies may include free Human Resources advice accessible by hotline. Any and all coverage contemplated must insure both skilled and non-skilled home care and temporary medical staffing. For each line of Liability coverage below, you must name BrightStar Group Holdings, Inc., a Delaware corporation, its subsidiaries, officers, directors, and employees, and any other person or entity we may designate in the future as Additional Insureds.
Source: Item 16 — RESTRICTIONS ON WHAT THE FRANCHISEE MAY SELL (FDD pages 80–81)
What This Means (2025 FDD)
According to Brightstar Care's 2025 Franchise Disclosure Document, the franchisee is responsible for the costs associated with complying with state-specific operational and technology requirements related to Medicaid participation. Specifically, if a state requires Electronic Visit Verification (EVV) for participation in Medicaid waiver programs, the franchisee bears the cost of using state-specified EVV systems. This includes the cost of integrating Brightstar Care's ABS (Agency Business System) with state aggregators or third parties selected by the state.
The franchisee is required to pay a one-time fee of $1,000 per aggregator for the initial setup and testing of the integration between ABS and the state's EVV system. Additionally, there is an ongoing charge of $0.50 per record processed each month to cover the maintenance costs of supporting the integration and any changes required by the state. The franchisee must notify BrightStar Technology at least 90 days before the state's EVV implementation date or any subsequent EVV version upgrade dates. Failure to provide timely notification may result in additional charges of up to $1,000 for the initial integration and up to $500 for any subsequent EVV version upgrade.
Even if the franchisee chooses to use another state-approved EVV provider, they are still obligated to pay Brightstar Care the $1,000 integration fee per aggregator and $500 for each EVV version upgrade required by the state. Any additional fees charged by the third-party EVV provider are the franchisee's responsibility. Furthermore, the franchisee is responsible for purchasing any software necessary to meet state-specific requirements of a state program or segment of business unique to their location and/or state. These stipulations highlight the importance of understanding and preparing for state-specific requirements to minimize potential costs and ensure compliance.