At first glance, combining scheduling, EVV, billing, and payroll may seem efficient. But for New York home care agencies, especially those downstate and covered by the Wage Parity Law, that convenience creates a compliance issue: What happens when the same software vendor responsible for EVV and billing Medicaid is the same vendor doing payroll (and has records proving that the workers were not paid correctly for Medicaid-reimbursed work)? As discussed herein, the State may arguably have found the easiest way to identify providers and employers who violate Medicaid and labor laws.
Medicaid Payment is Conditioned Labor Compliance
New York Public Health Law § 3614-c is unusually direct with respect to home care providers and payors’ obligations: no government payment may be made for an episode of care furnished by a home care aide who was compensated below the applicable minimum rate of total compensation. Section 3614-c is the State’s Wage Parity Law, and it applies to fee-for-service and MLTC claims. The Wage Parity Law prohibits any payor, including a MLTC, to reimburse a provider for home care services if the home care agency does not comply with the wage and benefits requirements of the Wage Parity Law. Thus, if there is no compliance with the wage and benefits requirements of the law, a provider is not allowed to bill for the hours of care provided.
And because the Wage Parity Law applies to CHHAs and MLTCs, the implications of this article apply to the full spectrum of home and community-based service providers.
In addition to a certification of compliance being embedded in every bill (or claim for payment), the Wage Parity Law itself requires LHCSAs, CHHAs, and MLTCs to annually certify compliance with the Wage Parity Law.
Submitting a Claim for Reimbursement that does not Comply with the Wage Parity Law Implicates the False Claims Act
Submitting claims that do not comply with the Wage Parity Law may violate the federal and New York False Claims Acts. Both statutes impose civil liability that can include three times, or treble, the government’s damages, in addition to a separate civil penalty for each false claim. In other words, for every Medicaid hour billed for a wage parity hour of care that did not comply with the wage and benefits requirements of the Wage Parity Law, the provider may be required to pay three times the amount that the provider received as reimbursement. Related conduct may also expose a provider or responsible individuals to liability under separate criminal statutes.
When Does a Payroll Error Become a False Claims Problem?
Home care providers are well aware that the State of New York has already pursued home care agencies under the federal and state False Claims Acts for obtaining Medicaid funds after certifying compliance with wage-parity requirements when aides allegedly had not received the required wages and benefits.
In September 2024, two Brooklyn home care agencies agreed to pay $9.75 million to resolve federal and state fraud claims and an additional $7.5 million to compensate underpaid aides. The government alleged that the agencies sought and received Medicaid reimbursement after certifying wage-parity compliance even though their aides had not received the required compensation. U.S. Attorney’s Office for the Eastern District of New York
The financial consequences became even clearer in December 2025, when the New York Attorney General announced a settlement with a large home care provider related to 10,000 workers. As part of the settlement, the provider agreed to return nearly $45 million in unpaid compensation to current and former aides and to pay an additional $10 million—$6 million to New York and $4 million to the federal government—to resolve related state and federal False Claims Act liability. The combined $55 million resolution was described by the Attorney General as the largest wage-parity settlement her office had secured. New York State Office of the Attorney General
The New York False Claims Act reaches a person who knowingly presents—or causes to be presented—a false claim for payment, as well as a person who knowingly makes or uses a materially false record or statement. The federal False Claims Act contains parallel provisions. Under both statutes, “knowingly” includes actual knowledge, deliberate ignorance, and reckless disregard; no specific intent to defraud the government is required before a provider may be liable for false claims that have been billed.
An Integrated EVV, Billing, and Payroll Vendor = An Obvious Conflict of Interest
For an integrated EVV, billing, and payroll vendor, there appears to be a clear conflict of interest:
- Does the EVV/billing vendor allow processing of billing claims, when its own payroll records reveal that the billed hours are based on work hours not paid correctly?
- Is an EVV/billing vendor able to serve as the State’s aggregator….when it knows or should know that the claims being submitted through its platform for payment are not wage parity compliant (and now, as a payroll provider, that EVV vendor/billing company has proof of wage parity violations)?
- Does the EVV/billing vendor have a responsibility to report payroll errors to the State? The EVV/billing vendor cannot serve as an aggregator or facilitate violations of the law, so if it knows (or should know) of payroll errors, can the EVV/billing vendor even do its job as the billing entity/aggregator without reporting the home care agency whose payroll is noncompliant?
- As these questions illustrate, the risk is real enough that agencies should not assume their payroll information will remain isolated from their EVV and Medicaid billing activity.
New York Agencies not Covered by the Wage Parity Law Should be Concerned Also
For upstate providers not covered by the Wage Parity Law, the typical wage risks remain: double damages. For every incorrect payment, the employee is entitled to double his or her unpaid wage. So for every $1.00 owed to an employee, the employer is actually exposed to $2.00 in damages. And do billing and EVV vendors really know the payroll laws that well to guarantee compliance? Further, for every incorrect pay statement, the employee is entitled to $250, up to $5,000 per employee.
Convenience does not Outweigh Legal Risk and Exposure
Combining EVV, billing, and payroll may reduce administrative work for the payroll team. However, that convenience is quickly outweighed by the risks and exposure that the provider undertakes by giving its payroll data to a vendor who has separate compliance and anti-fraud obligations to New York and federal state, by virtue of it being a EVV vendor and aggregator. It is difficult to reconcile how that EVV/ billing vendor can even perform its obligations to the federal government and New York State unless it stops billing or payroll (when an error is found) and affirmatively reports payroll errors to MLTCs and New York State.
As providers well know, in the eyes of the State—and your EVV and payroll vendor—the home care agency remains responsible for paying employees correctly. The fine print in any vendor’s contract clearly spells that out. Meanwhile, the wage laws and wage parity requirements remain complicated and ever-changing. Their compliance and oversight is not just a simple “payroll system” function that can be delegated to a billing/EVV vendor out of convenience.
If you have any questions about this article, please contact any attorney at Poricanin Law.
