SECTION 354.4007. EVV System  


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  • (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