Enforcement of compliance requires reliable, trustworthy, and expensive tech support for EVV tech issues which arise all day and night long.  The fiscal agents' IT/Tech departments are not available to the consumer/EOR/attendant, so that issues can be resolved.  Federal policy gives the states the ability to individualize the program designs.  If you are going to mandate that your state citizens must abide by the rules or be fined or face legal action, then I suggest you also mandate that the fiscal agents you approve to work in the state with Medicaid must abide by the same rules.  The threat to the public who are just trying to work within the state's expectations should be imposed on all parties involved in the policy that you made law.  The fiscal agent does not offer evening or Saturday hours and, yet, the disabled are clocking in and out round the clock and needing tech assistance round the clock.  Why is it that everything app. related is "tech issue" and they have to give a call back or an email back and the call and emails never come back?  We as the attendants can't talk to tech, but the customer service rep. also can't talk to tech.  So we are left to hope that the rep wrote the correct thing and hope that a tech person gets it and follows up.