February 7, 2019

Managed care organizations and HHSC fee-for-service contract monitoring staff must offer appeal rights to providers in writing prior to recoupment of funds. MCOs and HHSC fee-for-service contract monitoring staff may not recoup funds until the provider has exhausted all appeal rights.

MCO providers who have appeal rights or MCO EVV recoupment complaints with their MCOs should email HPM_Complaints@hhsc.state.tx.us with supporting documentation.

Fee-for-service providers who experience issues with fee-for-service contract monitoring related to MEDsys EVV data should email Electronic_Visit_Verification@hhsc.state.tx.us.