Electronic Visit Verification (EVV) has become a cornerstone of healthcare practices, guided by the 21st Century Cures Act passed in 2016. A crucial element of this legislation is the implementation of EVV by Medicaid personnel and home health care providers by January 1, 2019. Failure to meet this deadline could result in reduced Federal medical assistance. The Federal EVV mandate mandates providers to electronically verify essential service details:
– Type of service performed
– Member receiving the service
– Date of service
– Location of service delivery
– Care provider responsible
– Time the service begins and ends
While the EVV mandate is a significant component of the federal 21st Century Cures Act, individual states, including New York, have taken further steps to augment these requirements. The objective of such state-specific additions is to ensure comprehensive compliance with EVV standards, attuned to the unique healthcare landscape of each region.
In the state of New York, the Office of the Medicaid Inspector General provides a clear definition of EVV: it’s “an innovative method that utilizes electronic means to accurately capture the services provided to a Medicaid beneficiary at the precise point when the service is delivered.” This succinct yet comprehensive explanation captures the essence of EVV’s role in healthcare practice.
Who Is Affected?
Providers whose services exceed $15 million in Medicaid fee-for-service and care reimbursements are impacted. Certified home health agencies, long-term home health agencies, and personal care providers must comply.
What Do EVV Requirements Mean for Your Business?
Your Verification Organization (VO) and EVV system need not originate from the same vendor. A Verification Organization (VO) ensures EVV system adherence for New York agencies. Providers have the flexibility to choose an EVV solution that suits their needs and aligns with state standards.
Provider agencies and FIs are mandated to offer training to caregivers, agency staff, and EVV system users submitting EVV data to the New York State Department of Health (NYSDOH). Annual refreshers are also required.
Compliance Review Process:
NYSDOH reserves the right to conduct compliance reviews, covering EVV attestation and data submission requirements. Complete and accurate EVV data submission to New York’s EVV Data Aggregator and annual EVV Attestation to NYSDOH are essential. Personal care services (PCS) became subject to attestation and data submission on January 1, 2021, while home health care services (HHCS) will be affected from January 1, 2023.
– Review EVV Applicable Billing Codes
– Select an EVV Solution
– Complete the EVV Attestation
– Test EVV Solution with the NYS Aggregator
– Submit Production Data to the NYS Aggregator
– Prepare Medicaid Beneficiaries for EVV
For comprehensive details, visit http://www.ny.gov/agencies/office-medicaid-inspector-general or email questions to EVVHelp@la.gov. Adhering to New York’s EVV requirements ensures compliance and maintains the quality of care in the evolving landscape of healthcare.