This year, HHSC is creating an open model for electronic visit verification to allow a program provider or financial management services agency to implement the use of their own EVV proprietary system to meet EVV requirements.
What is an EVV Proprietary System?
An EVV proprietary system is an HHSC-approved EVV system that a program provider or financial management services agency may opt to use, instead of an EVV vendor system from the state vendor pool that:
- Is purchased or developed by a program provider or FMSA;
- Is used to exchange EVV information with the EVV Aggregator;
- Complies with Section 531.024172 of the Texas Government Code and
- Complies with all HHSC EVV standards, rules and reporting requirements.
EVV System Options
Texas Medicaid program providers and FMSAs have two options for complying with the requirement to use an EVV system.
Option 1: State EVV Vendor Pool
Program providers and FMSAs can choose to use an EVV vendor system from the state EVV vendor pool managed by the Texas Medicaid & Healthcare Partnership.
TMHP contracts with EVV vendors to provide EVV systems at no cost to program providers and FMSAs. See the TMHP EVV Vendors webpage for more information and instructions for choosing a vendor system.
Option 2: EVV Proprietary System
Program providers and FMSAs may choose to seek HHSC approval to use an EVV proprietary system instead of an EVV vendor system from the state vendor pool.
HHSC may recognize a proprietary system, whether purchased or developed by the program provider or FMSA. EVV proprietary system operators will be responsible for their system meeting all provisions of state and federal laws, rules, regulations, policies, and guidelines, including the requirements of Section 531.024172(g) of the Texas Government Code and all other EVV requirements.
See the TMHP EVV Proprietary Systems webpage for more information and instructions for choosing a proprietary system.
Update: Effective May 6, TMHP will not accept additional EVV proprietary system requests. A new process to manage the large number of applications will be announced this fall or sooner.
Although individual implementation plans may vary, the timeline below provides a general overview of the time needed to implement an EVV proprietary system.
Currently Required to Use EVV
- Existing program providers and FMSAs currently delivering services subject to EVV requirements by state law and using an EVV vendor system are not subject to the milestones in the timeline below.
Will be Required to Use EVV by Jan. 1, 2021
- Program providers and FMSAs not currently using EVV, but subject to use EVV mandated by the 21st Century Cures Act (Cures Act), may seek HHSC approval to implement an EVV proprietary system.
- Program providers and FMSAs must follow the implementation timeline below to ensure EVV requirements are met by Jan. 1, 2021.
- If an EVV proprietary system is unable to be implemented by Oct. 30, an EVV vendor system must be selected to ensure EVV requirements are met.
Note: Dates are subject to change. Additional dates will be added if needed.
Jan. 31, 2020
HHSC publishes the HHSC EVV Proprietary System Business Rules and EVV Proprietary System Request Form on the TMHP EVV Proprietary Systems webpage.
May 1, 2020
Program providers and FMSAs subject to the Cures Act must select to use their EVV proprietary system (or an EVV vendor system from the state EVV vendor pool) and submit the request form to TMHP. Note: The original deadline was April 1, but was extended in response to COVID-19.
- After May 1, HHSC assigned an EVV vendor system to Cures Act program providers and FMSAs that did not make a selection and they were notified by TMHP of their assigned vendor and next steps.
By Oct. 30, 2020
Program providers and FMSAs subject to the Cures Act must complete the EVV proprietary system readiness review, receive HHSC approval, and implement the proprietary system no later than Oct. 30.
- Important: If a proprietary system is unable to be implemented by Oct. 30, an EVV vendor system must be selected to ensure EVV requirements are met by Jan. 1, 2021. The program provider or FMSA can transition to their proprietary system at a later date.
HHSC is exploring reimbursement to a program provider or FMSA for using an HHSC-approved EVV proprietary system if feasible. Currently reimbursement is unavailable. HHSC will update this webpage when more information about reimbursement is known.
EVV Proprietary Systems Workgroup
Senate Bill 1991 (86th Legislature) required HHSC to consult with industry stakeholders about creating an open model for EVV and using an EVV proprietary system. Accordingly, HHSC hosted workgroup meetings in 2019. Materials discussed during each workgroup are below.
Note: Materials presented in the workgroup are drafts only used for discussion purposes. Final versions of these materials are available on the TMHP EVV Proprietary Systems webpage.
Meeting 1: Oct. 1, 2019
- Meeting 1 Presentation (PDF)
- This presentation provides background and legislation, an overview of EVV systems, and proposed documentation, processes and timelines for review by workgroup participants.
- Draft Overview of EVV Proprietary Systems Onboarding Process (PDF)
- This draft document provides an overview of expectations for developing, testing, updating and maintaining an EVV proprietary system.
- Draft Proposed TAC Rules and HHSC EVV Policy Handbook Revisions for EVV Proprietary Systems (PDF)
- This draft document includes potential TAC rules and EVV Policy Handbook revisions. Note, this is not a formal TAC rule proposal.
Meeting 2: Oct. 22, 2019
- Meeting 2 Presentation (PDF)
- This presentation provides an overview of the EVV proprietary system onboarding process, proposed TAC rule changes, HHSC EVV Policy Handbook revisions, and draft business rules.
- Draft HHSC EVV Business Rules for Proprietary Systems (PDF)
Meeting 3: Nov. 12, 2019
- Meeting 3 Presentation (PDF)
- This presentation provides an overview of draft business rules related to user onboarding, establishing service, and electronic verification methods. Also outlines draft business rules appendices.
- Draft HHSC EVV Business Rules for Proprietary Systems (PDF)
- Draft EVV Master Provider Web Service Appendix D of HHSC EVV Business Rules (PDF)
Meeting 4: Dec. 3, 2019
- Meeting 4 Presentation (PDF)
- This presentation provides an overview of draft business rules related to service delivery verification and reporting requirements. It also includes an overview of the operational readiness review process and two draft business rules appendices.
- Onboarding and Operational Readiness Review Process
- Appendices of HHSC EVV Business Rules for Proprietary Systems:
To submit feedback or questions, email Electronic_Visit_Verification@hhsc.state.tx.us.