SECTION 354.4005. Applicability  


Latest version.
  • (a) Entities subject to this subchapter. The requirements in this subchapter apply to a program provider, a consumer directed services (CDS) employer, a financial management services agency (FMSA), a service provider, a member, and a managed care organization (MCO) unless otherwise specified in the text.

    (b) Services subject to this subchapter. The use of electronic visit verification (EVV) is required for all service delivery options for the following services:

    (1) personal attendant services provided in the Community Attendant Services Program;

    (2) personal attendant services provided in the Family Care Program;

    (3) personal attendant services provided in the Primary Home Care Program;

    (4) Community First Choice (CFC) services delivered through the traditional Medicaid service model also referred to as fee-for-service:

    (A) Community First Choice Personal Assistance Services (CFC PAS); and

    (B) Community First Choice Habilitation (CFC HAB);

    (5) personal care services (PCS) provided under the Texas Health Steps Comprehensive Care Program;

    (6) Community Living Assistance and Support Services Program services:

    (A) CFC PAS/HAB; and

    (B) in-home respite;

    (7) Deaf Blind with Multiple Disabilities Program services:

    (A) CFC PAS/HAB; and

    (B) in-home respite;

    (8) Home and Community-Based Services (HCBS) Adult Mental Health Program services:

    (A) supported home living - habilitative support; and

    (B) in-home respite;

    (9) Home and Community-based Services Program services:

    (A) CFC PAS/HAB;

    (B) respite provided in a member's residence; and

    (C) day habilitation provided in a member's residence;

    (10) State of Texas Access Reform (STAR) Health Program services:

    (A) CFC PAS;

    (B) CFC HAB;

    (C) PCS; and

    (D) Medically Dependent Children Program (MDCP) STAR Health covered service:

    (i) in-home respite; and

    (ii) flexible family support;

    (11) STAR Kids Program services:

    (A) CFC PAS;

    (B) CFC HAB;

    (C) PCS; and

    (D) MDCP STAR Kids covered service:

    (i) in-home respite care; and

    (ii) flexible family support;

    (12) STAR+PLUS Program services:

    (A) personal assistance services;

    (B) CFC PAS; and

    (C) CFC HAB;

    (13) STAR+PLUS HCBS Program services:

    (A) in-home respite care;

    (B) protective supervision;

    (C) personal assistance services;

    (D) CFC PAS; and

    (E) CFC HAB;

    (14) STAR+PLUS Medicare-Medicaid Plan services:

    (A) in-home respite care;

    (B) protective supervision;

    (C) personal assistance services;

    (D) CFC PAS; and

    (E) CFC HAB;

    (15) Texas Home Living Program services:

    (A) CFC PAS/HAB;

    (B) respite provided in a member's residence; and

    (C) day habilitation provided in a member's residence;

    (16) in-home respite provided in the Youth Empowerment Services Program; and

    (17) any other service required by federal or state mandates.

Source Note: The provisions of this §354.4005 adopted to be effective December 23, 2020, 45 TexReg 9178