July 24, 2019

Effective Sept. 1, program providers will be reviewed on using the EVV system to electronically document authorized service delivery visits.

  • New EVV Usage Policy
    • Program providers will be reviewed for visit transactions manually entered into the EVV system and visit transactions rejected by the EVV Aggregator.
    • EVV usage replaces the current EVV compliance plan score reviews.
    • A program provider’s use of preferred and nonpreferred reason codes will not be used to calculate the usage score for visits with dates of service on and after Sept. 1, 2019.
    • Program providers currently required to use EVV will receive a usage grace period for visits with dates of service between Sept. 1, 2019, through Aug. 31, 2020.
  • Revised Policy for EVV Reason Codes and Required Free Text
    • Program providers will be reviewed for appropriate use of reason codes and entry of required free text.
    • Reason codes are required in the EVV system to clear visit exceptions. However, program providers will not be assessed for misuse of reason codes for visits with dates of service between Sept. 1, 2019, through Aug. 31, 2020.
    • Program providers must document required free text—there is no grace period.
  • Revised Policy for EVV Allowable Phone Identification
    • Program providers will be reviewed for allowable home landline phone types used to clock in and clock out of the EVV system.
    • There is no grace period for allowable phone identification reviews.

Read the full EVV Compliance Oversight Reviews policy.

New EVV Claims Policies

  • Billing Policy
    • ​​​​​​​Requires program providers to follow the billing guidelines of their payer for EVV claims.
  • Claims Matching Policy
    • ​​​​​​​Requires that any claim for EVV services be matched to an accepted visit transaction in the EVV Aggregator, prior to payment of a claim, to confirm that a service visit occurred.
    • An EVV claim that does not match an accepted visit transaction will be denied by the payer.
    • All EVV payers will implement the new claims matching policy on Sept. 1, 2019. 
  • Claims Submission Policy
    • ​​​​​​​Requires program providers to submit EVV claims to Texas Medicaid & Healthcare Partnership for EVV services.

Read the full version of each policy above.

EVV Training, Vendor Selection, Vendor Transfer and Data Elements Policies

  • New Training Policy
    • ​​​​​​​Requires HHSC and MCO program providers to complete all required training prior to using an HHSC-approved EVV system and annually thereafter.
    • Program providers using EVV prior to Sept. 1, 2019, will be required to take the EVV Aggregator, portal and policy training on or before Dec. 31, 2019, and annually thereafter.
  • Revised Vendor Selection Policy
    • ​​​​​​​Requires program providers to select an HHSC-approved EVV vendor within 30 business days of receiving a contract with HHSC or an MCO.
  • Revised Transfer Policy
    • ​​​​​​​Requires program providers to request a transfer to another HHSC-approved EVV vendor 120 calendar days prior to the desired transfer date.
  • Revised Data Elements Policy
    • ​​​​​​​Requires the following visit data categories to be electronically verified by an HHSC-approved EVV system:
      • Program provider
      • Type of service performed
      • Member receiving service
      • Date and time of service
      • Location of service delivery
      • Person providing the service
    • Program providers must ensure data elements in the EVV system are accurate and complete.
    • Missing or incorrect data elements in the EVV system will result in rejected visit transactions, denied or recouped claims, inaccurate standard reports and inaccurate data.

Read the full version of each policy above.

Revised EVV Standard Reports Policy

  • Standard reports located in the EVV portal and vendor system are the official reports HHSC and MCOs use for oversight and data analysis, not limited to:
    • HHSC contract monitoring
    • HHSC EVV compliance oversight reviews
    • Fraud, waste and abuse reviews
  • Only EVV portal standard and vendor standard reports will be used during HHSC or MCO contract monitoring, recoupment projects, or other oversight or review activities.
  • EVV visits with date(s) of service prior to Sept. 1, 2019, will be available in the DataLogic Vesta EVV system.

Read the full version of this policy.

Contact HHSC EVV Operations with any questions.