In accordance with Chapter 59 of the Laws of 2011, as amended in 2014, certain providers of home health services that exceed $15 million in Medicaid fee-for-service and/or Medicaid managed care reimbursements are required to utilize a verification organization (VO) to perform a pre-claim review prior to billing the state. The VO must verify the home health services within a claim or encounter collected from electronic visit verification (EVV) prior to submission of the claim or encounter to the Department of Health (DOH) or to a managed care provider.
The Office of the Medicaid Inspector General (OMIG) has identified the participating providers that are required to utilize a VO. Those providers required to participate are notified by the OMIG via certified letter. Only providers that receive notification from OMIG are required to have their services verified by a VO. If you have any questions regarding your status under the amended law please contact OMIG at (518) 402-1470 (518) 402-1470.
Providers requiring a VO must select their VO from the OMIG and DOH joint list of approved VOs, which can be found on their website at http://omig.ny.gov under the Resources tab. Follow the Verification Organizations link. The VO you select does not have to be the same vendor you utilize for your EVV services.
Additional information and resources related to the law can be found on the OMIG website at http://omig.ny.gov under the Resources tab. Follow the Home Health Requirements and/or Questions and Answers links.
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