The Texas Health and Human Services Commission or the applicable Managed Care Organization and provider agency must adhere to the following policy if an attendant delivering services is found to be calling in and out of the Electronic Visit Verification system from a telephone number originating from an unallowable phone type through the EVV Vendor Phone Sampling Report or other phone sampling reports. The policy is effective March 1, 2018.
Unallowable Phone Identification Written Notice:
- HHSC or the MCO must notify the provider agency in writing when they have identified a phone number originating from an unallowable device.
- The written notification to the provider must include, at a minimum, the following information:
- Phone number identified
- Phone type
- Dates the phone number was used to clock in and/or out
- Attendant associated with the EVV check in/out
- Individual’s first and last name
- Individual’s Medicaid number
- Date HHSC or MCO identified the phone number associated with the device
- List of supporting documentation the provider can submit to validate the identified unallowable phone number(s) is not a cellular or smart phone or a Voice over Internet Protocol(VoIP)
- HHSC or MCO contact information the provider can call for assistance
- HHSC or the MCO must provide the provider agency a copy of the EVV Vendor Phone Sampling Report or other phone sampling reports used to identify the unallowable phone type.
Provider Agency Required Action:
Provider agency must take one of the following actions within twenty (20) business days from the date of receipt of the written notice:
- Request and install a small alternative device (SAD); or
- Submit supporting documentation showing the identified unallowable phone number(s) is not a cellular or smart phone or a VoIP.
HHSC or the MCO will review all supporting documentation submitted within the required timeframe and provide written notice of a decision. If the supporting documentation submitted by the provider cannot verify the unallowable phone number as an allowable landline phone the visit(s) identified in the written notice are subject to recoupment. Supporting documentation may include, but is not limited to:
- Internet search sites such as White Pages
- Documentation from the phone company
If the provider agency did not receive the requested SAD within ten (10) business days the provider agency should immediately notify the payor identified on the written notice and HHSC EVV operations staff.
The provider agency will be in compliance with no further action necessary when:
- verification can be provided from the EVV vendor that a SAD has been requested within the twenty (20) business days; or
- the provider receives written notification from HHSC or MCO that the supporting documentation submitted verified the unallowable phone number as an allowable phone type.
Provider Agency Fails to take Action:
If the provider agency fails to request and install a SAD or submit supporting documentation to HHSC or the MCO within twenty (20) business days from the date of the written notice, HHSC or the MCO may take compliance or contract action against the provider agency including recoupment of the visit(s) identified in the written notice.
If an unallowable phone number had been previously identified and was later used for EVV visits after the provider received written notification, those visits may be subject to recoupment.
Allowable Phone Types:
Home telephone service where the phone cannot be disconnected and used at a different address/location. This includes phone service through the local:
- Wired phone connected to a phone jack in the wall
- Cable internet provider (e.g., Time Warner, Comcast, AT&T, etc.)
Unallowable Phone Types:
- Phone service provided over a cellular, satellite or other mobile network is not acceptable.
- Portable alternative phone services that use VoIP, including but not limited to MagicJack, Vonage, Skype or GoogleVoice.
How is an unallowable phone type identified?
The EVV vendor will sample all numbers used to verify EVV visit records on a monthly basis, starting March 1, 2018. The EVV Vendor will publish the results of their phone sampling for the previous month in the Phone Sampling Report located under Standard Reports. Providers can use this report to monitor phone types being used to verify service delivery. Please refer to your EVV vendor for information on this report.
What action should a provider agency take if they identify an unallowable phone type?
If the agency discovers an unallowable phone number was used to verify visits, the provider should order and install a SAD immediately.
Contact HHSC EVV Operations at email@example.com or the appropriate MCO for questions regarding this policy.