(a) Use of an EVV System.
- (1) A program provider, consumer directed services (CDS) employer, and financial management services agency (FMSA) must ensure an electronic visit verification (EVV) vendor system or an HHSC-approved EVV proprietary system is used to electronically document the delivery of a service described in §354.4005 of this subchapter (relating to Applicability).
(2) A program provider, CDS employer, and FMSA must:
(A) ensure that each EVV visit transaction contains the following data elements, including identifying information, as required by HHSC, for:
- (i) the type of service provided;
- (ii) the name of the member who received the service;
- (iii) the name of the service provider who provided the service;
- (iv) the date of the service;
- (v) the time the service began and ended;
- (vi) the location, including the address, at which the service was provided; and
- (vii) other information HHSC determines necessary to ensure the accurate payment of a claim for services, as described in the EVV Policy Handbook;
- (B) ensure the accuracy of the data elements on each EVV visit transaction; and
- (C) comply with all HHSC requirements for correcting or noting an inaccurate data element.
(b) Access to an EVV System.
- (1) A program provider must allow HHSC or a managed care organization (MCO), with which they contract, immediate, direct, on-site access to the EVV system the program provider uses.
- (2) An FMSA must allow HHSC or an MCO with whom the member is enrolled and with whom the FMSA contracts, immediate, direct, on-site access to the EVV system the FMSA uses.
(c) Access to Documentation.
- (1) A program provider and an FMSA must ensure that HHSC can review EVV system documentation or obtain a copy of that documentation at no charge to HHSC.
- (2) A program provider and an FMSA must ensure an MCO, with which a claim for payment for a service is filed, can review EVV system documentation related to the claim or obtain a copy of that documentation at no charge to the MCO.
Source Note:The provisions of this §354.4007 adopted to be effective December 23, 2020, 45 TexReg 9178.