Providers and Fiscal Intermediaries of Medicaid-Funder HHCS were required to implement EVV system by January 1, 2023. Many providers were already using Electronic Visit Verification (EVV) as a proactive tool to increase operational efficiencies. The January 1 deadline added an additional requirement to submit EVV data to the NYS EVV Data Aggregator (EMedNY). The data is used for reporting and audit purposes.
Understanding the Process
During the initial implementation process, Visiting Aid ensures that all proper documentation is submitted to New York State. This requires the agency to complete an EVV Attestation with EMedNY. This attestation will include Visiting Aid details as the EVV submitter.
In addition to selecting a technology vendor, all home agencies need a compliance policy regarding EVV. This policy should include the following:
1. Data Collection and Aggregation Procedure: EVV data will be collected in real-time and aggregated daily for subsequent review.
2. Accuracy Check Procedure: Key data fields such as time, location, and service type must be verified for accuracy against service logs.
3. Error Identification Procedure: Utilize automated tools to flag discrepancies and conduct a manual review for more complex errors. On a weekly basis the Agency will run a data aggregation report to review for errors.
4. Correction and Resubmission Procedure: Promptly correct any identified errors and resubmit the updated data to the state aggregator.
5. Compliance Monitoring Procedure: Generate quarterly compliance reports and ensure regular system updates to meet legal requirements.
6. Training and Support Procedure: Conduct regular staff training on the use of the EVV system and provide necessary support for data entry and error correction.
7. Audit and Review Procedure: Perform quarterly internal audits and arrange for an external audit annually.
8. Documentation Procedure: Maintain comprehensive records of all reviews, corrections, staff training, and system updates for accountability and compliance purposes.
1) When is agency data submitted to New York State?
a. To ensure that only accurate data is submitted to NYS, Visiting Aid will send EVV data after the visit has been billed and/or processed for payroll.
b. For agencies that do not use Visiting Aid for billing or payroll, all clean visits are submitted no later than 3 weeks after the visit date.
2) What visits are submitted to NYS OMIG?
a. Visiting Aid only submits EVV data for visits that are marked for Medicaid billing. Private pay visits and non-Medicaid visits are not submitted to NYS.
3) How does any agency see if there is an error in data submission?
a. Visiting aid ensures that all agencies are notified immediately if that is any discrepancy is data transmitted. This data is available in the alerts section of your dashboard showing as “Inaccurate Data.” This alert will only be cleared when your team corrects the error in the system. Once corrected Visiting Aid will resubmit the data to NYS
4) Can an agency run a report to see the EVV data log?
a. This report is available under the Reports - > Admin section. Report is called EVV State Aggregator Log.
5) Does OMIG have a required utilization percentage that needs to be followed?
a. OMIG does not have a posted EVV percentage that is required for all agencies; however, OMIG is actively monitoring EVV and Visiting Aid recommendation that all agencies continually improve EVV metrics to ensure more efficient operations, faster billing, and reduce audit risk.
6) What do I do if I receive a letter from OMIG regarding EVV Compliance?
a. It is important that these letters are not ignored. Visiting Aid is your compliance partner, and we recommend you contact us immediately to assist with this process. Visiting Aid will assist you with doing an EVV audit.
b. Visiting Aid has Reports to help you with an EVV Audit, they are found under Reports -> Admin>EVV State Aggregator Log>choose the date range and select >Errors Only from the drop down menu.
Your agency can easily view any errors that may have occurred and send the list to the email on the OMIG letter, most errors are caused by simple data entry mistakes such as an incorrect DOB, incorrect medicaid number ect.
C. In order to show your agency EVV statistics, please navigate to Reports>Statistical DOH>Electronic Visit Verification and view the report, it can also be exported and used to report agency compliance.
d. If you receive a letter from OMIG requiring a response, here are suggestions for best practice:
In your response
Use a narrative format to state, “This is our assessment of our EVV compliance,and this is why and this is how we intend to improve that rate” In other words: Outline the data you’re sending.Estimate your organization’s compliance percentage,
and give the reasons for non-compliance (staff issues, connectivity issues, etc.). Describe compliance barriers
and any concerns you have with data collection, EVV vendors, etc. Explain your ideas for an improvement
plan, if you have one. Your responses will help the state identify where the problems lie. According to OMIG, even if your EVV compliance is zero, you will still benefit from explaining this in your response.
Visiting Aid reminds our operators that the very first point OMIG made was to iterate that “there is not a
problem” with EVV and this is not a punitive initiative. The information will be used to set policy and improve
the state’s processes. OMIG expects every operator to respond to the letter. If you feel you need more time, email OMIG and request an extension, which they say they will grant. Their opinion is that good information is better than fast information. There are no anticipated consequences for not responding, but those who don’t participate won’t have their concerns considered.
EVV and Claims
Visiting Aid reminds operators that the Department is not yet linking claims adjudication to EVV data. In other words,
payments from Medicaid and plans do not depend on accurate EVV submissions. However, in the future, this
WILL be the case. That is why it’s so important to rectify any EVV issues now – before your reimbursements are affected
Visiting Aid (Verification Organization)
Visiting Aid has been aggregating data for home care agencies since (Date) as a New York State Approved Verification Organization. This designation means that Visiting Aid already has the necessary systems in place for your agency.