NY Medicaid Electronic Visit Verification Program (EVV)

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Program Information

21st Century Cures Act Requirements

The 21st Century Cures Act, is a federal law, passed by Congress in December 2016, that in part requires all state Medicaid programs to implement an EVV system for personal care services (PCS) and home health care services (HHCS). All states must implement an EVV system to avoid a reduction in federal Medicaid funding. The Cures Act includes a provision that allows for the delay of implementation for up to one year if a state has encountered unavoidable delays, as demonstrated in a good faith effort (GFE). On December 5, 2019, the New York State Department of Health´s EVV GFE exemption request was approved by the Centers for Medicare and Medicaid Services (CMS).

As such, the New York State Department of Health (NYSDOH) required providers of Medicaid-funded PCS to select and implement EVV systems that meet the requirements of the 21st Century Cures Act by January 1, 2021. Providers of Medicaid-funded HHCS will be required to select and implement compliant EVV systems by January 1, 2023.

For more information on the federal law and requirements for EVV, visit:
Medicaid.gov

What is EVV?

EVV is a system that may include multiple point-of-care verification technologies, such as telephonic, mobile, and web-based verification inputs. The system electronically verifies the occurrence of home- or community-based service visits, identifying the time that service provision begins and ends to ensure accurate claims disbursement and helping to ensure that beneficiaries who are authorized to receive services get the expected care. EVV is used to:

Verify visits on a real-time basis, including date, location, type of service, individual(s) providing and receiving services, and duration of service(s)
Validate hours of work for home health employees
Eliminate billing data entry mistakes
Reduce costs related to paper billing and payroll
Help combat fraud, waste, and abuse