Updated EVV Guidelines and Reminders

In response to multiple questions about how providers should handle missed clock-ins and clock-outs for purposes of EVV, the New York Department of Health EVV Program Guidelines and Policy manual (available HERE) has been updated to address this issue. In relevant part, the EVV manual now states (with the underlined language being the newly added language):

All EVV services are required to have complete EVV data in order to be considered a verified visit. In the circumstance that a visit was not electronically captured at the time of the visit, the provider agency or Fiscal Intermediary (FI) may manually enter the visit information. All manual and edited entries require agency management approval or CDPAS consumer approval prior to adjustment and submission to the NYS Aggregator. Manually entered visits should only be used when absolutely necessary.

As we have addressed in prior alerts, EVV is mandatory for personal care services as of January 1, 2021 unless an exception to EVV applies (e.g., where the worker permanently resides with the patient). We still receive many questions from providers as to whether EVV applies to CDPAS or LHCSAs. However, there should be no uncertainty here by any provider; EVV is mandatory for all providers of personal care services.

Further, as we have also reported, the State expects providers to provide training to caregivers, consumers, and office staff of covered EVV providers, with such training to be completed for all “current” employees by August 1, 2021. Providers cannot rely on their EVV vendors’ brochures to provide this training. Instead, as per the EVV guidelines, the training has to cover certain requirements involving the EVV program that are not addressed by EVV vendor brochures, which generally focus on the logistics of utilizing EVV. Providers should take the time now to design and write proper training manuals, to ensure that they have sufficient time to train all their employees by the August 1, 2021 deadline.

Lastly, we take this opportunity to remind providers that EVV is intended to verify that the patient and caregiver were in the same location for the duration of the billed hours of service. EVV does not replace or somehow negate other requirements that providers must meet in order to be able to bill government payors (and Medicaid MLTCs) for services. Therefore, providers still have an obligation to ensure that they are complying with all the conditions and requirements for billing for their services. Specifically, and as an example, for LHCSAs, separate and apart from providers’ obligation to conform to the EVV requirements, providers must also continue to ensure that the services provided by caregivers comport with the plan of care for each and every hour of service.  And for fiscal intermediary services, irrespective of EVV requirements, providers must continue to have consumers verify the hours worked by their personal assistants.

If you have any questions about EVV, please do not hesitate to contact us.