New York (NYBU) Resources

In this help topic, we've collected resources to assist you with EVV in the state of New York. Click on any of the dropdowns to learn more.

To comply with regulatory and reporting requirements from New York State Medicaid Billing, agencies performing administrative services for Consumer Directed Personal Assistance Program (CDPAP) on or after August 1, 2024, for MCO and October 1, 2023, for HRA, can be reimbursed for administrative costs Per Month Per Member (PMPM).

The PMPM reimbursement is based on members':

  • Authorized hours for HRA per month.

  • Serviced hours for MCO per month.

Please refer to your payer guidelines for billing this administrative rate, as there may be different requirements, such as rate codes, timely filing, or billing process.

To enable this PMPM administrative service transactions, follow the setup and invoice process as stated in this document.

This file is available to assist in contacting agencies when a result appears on your agencies Conflict of Hours report.

The slides linked below review the following topics in regard to Emergency Preparedness:

  • Emergency Preparedness:

    • Disaster Levels - Patient Classification Levels

    • TAL Codes and Subcategories

    • Flood Zones

    • Emergency Equipment

    • Reporting

  • DOH Statistical Report Workflow

Click here to view the slides.

The Staff Maintenance File includes the staff’s DOB, SSN and classification for staff that have a change to their profile within the date range selected. This can easily be used pull an extract of all staff within your database if a large date range is selected.

Click here for more information.

This file helps users when determining what report to run.

Click here for instructions on supplying Processed Hour and Revenue amounts.

Click here for important information regarding Transportation Assistance Level (TAL) and Disaster Level Modifications.

If you have any questions, please contact Sandata Customer Support at (888) 311-6374.

The attached PowerPoint contains the following topics for review in regard to the NY Labor Updates:

  • Wage and hour updates

  • Wage and hour lawsuits

  • Wage and hour violations

  • Elimination of the federal companionship and live-in domestic service exemptions

  • Minimum wage continues to increase

  • United States Department of Labor proposes significant changes to regulations governing “White Collar” exemptions

  • Challenges to 13-Hour rule for live-in aides

  • Common wage and hour problems

  • Sandata overtime and sleep-in tracking features

Click here to view the file.

This DOH Statistical Report guide will walk you through how to run the reports and how to search for any unknown information. Click here to view the file.

The attached slide deck reviews the following topics:

  • Attendance Verification & Documentation of Manually Confirmed Visits

  • Conflict of Hours Investigation

  • Exclusions Screening

Click here to view the file.

To enable the attached sleep-in tasks, fill out the form below and email it to customersupport@sandata.com or fax to (718) 628-2276.

Click here to view the form.

This document contains instructions on entering and removing staff exclusions for a specific payor. Agencies use this procedure when the payor has indicated that a staff should not be working with any of the payor's patients. Once an exclusion has been entered, the system prevents the staff from being scheduled for any cases corresponding to the selected payor.

Click here to view the document.

The attached document reviews the following topics in regard to Reason & Resolution codes:

  • System settings

  • Setting up the OMIG reason codes crosswalk (admin users only)

  • Reviewing current reason codes and reason code crosswalk

  • Setting OMIG reason and resolution codes as required at the Payor

  • Verification staff (verifying a visit)

  • OMIG reason code reporting

  • OMIG individual client activity report

Click here to download the document.

Attached is the set up required for mapping DOH statistical reports. For these reports to return accurate data it is essential that all mapping is complete prior to running any of the reports.

Ensure that you review the DOH Statistical Report questions as the report does change annually, and the mapping such as the Discharge Type may need to be adjusted.

The attached slide deck reviews the following topics:

  • DOH Statistical Report Overview

  • Overall Workflow to Prepare your System

  • Analysis of DOH Statistical Report Forms

    • LSR2 - Patients

    • LSR3 & LSR4 - Revenue (Direct and Contracted)

    • LSR5 - Cost Form

    • LSR6 - Staff & Wages

    • LSR7 - Services by County

    • LSR8 - Contracts

    • LSR9WF - Workforce A, B & C

Click here to download the Statistical Report Mapping instructions.

Click here to download the slide deck.

The attached slide deck provides an overview of the following topics in regards to the 21st Century Cures Act:

How does Section 12006 of the Cures Act impact HCBS programs?

  • The Cures Act mandates that states require EVV use for Medicaid-funded Personal Care Services (PCS) and Home Health Care Services (HHCS) for in-home visits by a provider.

  • Section 12006 of the Cures Act was signed into law on December 13, 2016, and added section 1903(l) to the Social Security Act (the Act).

  • The requirement covers all 50 states including the District of Columbia, as well as the territories of Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa.

Click here to download the slide deck.

  • TVV is available as an alternate to the mobile check-in/check-out process. TVV should be utilized in cases where SMC is not available (e.g., the device has not been charged, connectivity issues, because the device has not yet been delivered, etc.).

  • When using TVV, caregivers can call-in/call-out from any authorized phone number listed in the client record.

  • Agencies are assigned two toll-free numbers for their account.

Click here to read more.

TVV Call In with Tasks Only

1 min.

TVV Call Out with Tasks Only

1 min.

  • Fixed Visit Verification is a way of capturing a caregiver’s start and end times for a visit without the use of a client’s landline phone.

  • It is the option to use when a client does not have a home landline phone or does not allow the caregiver to use their phone, and the caregiver cannot use the mobile App.

  • The process uses a small device that is registered to the client and remains in the client’s home.

Click here to read more.

FVV Call In and Out

2 min.

Sandata Mobile Connect allows an employee to start and end a visit without requiring the use of the client’s home phone. Sandata Mobile Connect is the primary and preferred method of calling in and out for client visits.

Click here to read more.

Click here to learn how to:

  • Access Nurse Assessment and your data.

  • Download the zip file that contains the program and your agency’s data and set it up for use.

  • Download the Nurse Assessment application.

  • Install it on a local computer at your agency.