1. HHSC Electronic Visit Verification
Overview
April 2019

2. What is EVV? EVV is a computer-based system that electronically:
Verifies that service visits occur; and
Documents the date and time service delivery begins and ends.

3. How does EVV Work?
When an attendant provides services to a member in the home or the community, the attendant will use one of three approved EVV time recording methods to clock in when service delivery begins and clock out when service delivery ends.
Mobile Application
Alternative Device
Member’s Home Phone Landline

4. What data is collected?
EVV electronically documents the following visit data:
Member receiving services
Attendant providing services
Location of service delivery
Date of service delivery
Time the attendant begins and ends service delivery

5. How is EVV data used? EVV visits are required for EVV claim payment.
Claims with EVV relevant services will be matched against visit data collected at a new system called the EVV Aggregator.
Claims that do not match the visit data will be denied by the payer of that claim (Managed Care Organization or TMHP).
The following critical data elements will be matched:
National Provider ID (NPI) or Atypical Provider ID (API)
Medicaid ID of individual receiving services
Date of service
Units of service
Type of service as identified by billing code

6. EVV Process Flow (Sept. 1, 2019)
* EVV Portal can be
accessed by Providers to view their EVV Visit Data for billing and Claims Matching results.

7. EVV Process Flow (January 1, 2020)
* EVV Portal can be
accessed by Providers to view their EVV Visit Data for billing and Claims Matching results.

8. 21st Century Cures Act
Section of the 21st Century Cures Act (Cures Act), is a federal law requiring all states to use EVV for Medicaid Personal Care Services and Home Health Care Services; including services delivered through the Consumer Directed Services (CDS) option.
States must implement EVV or risk a loss of federal Medicaid matching dollars.
Personal Care Services must start by Jan. 1, 2020
Home Health Care Services must start Jan. 1, 2023

9. Current Services Requiring EVV
21st Century Cures Act
Impact for January 1, 2020 – SRO/CDS
The following HHSC programs and services are currently required to use EVV.
Program
Current Services Requiring EVV
1915(c) Community Living Assistance and Support Services (CLASS) Waiver
CFC PAS/HAB and In-Home Respite
Community Attendant Services
Personal Assistance Services (PAS)
Family Care
PAS
Primary Home Care
STAR Health
CFC PAS, CFC HAB, and Personal Care Services (PCS)
STAR Kids
CFC PAS, CFC HAB, and PCS
STAR Kids - MDCP Covered Services
In-Home Respite and Flexible Family Supports
STAR+PLUS
CFC PAS, CFC HAB, and PAS
STAR+PLUS HCBS
PAS, In-Home Respite, and Protective Supervision
Currently, EVV is optional for individuals using the SRO/CDS option; however, with the passage of the 21st Century Cures Act, the use of EVV will be required when using the SRO/CDS option

10. 21st Century Cures Act New Program Services for January 1, 2020
Potentially Impacted:
YES Waiver – Community Living Supports
Home and Community-Based Services – Adult Mental Health – HCBS-AMH
New Program Services for January 1, 2020
Program
Services and Service Delivery Options Requiring EVV
(January 1, 2020)
1915(c) Deaf Blind with Multiple Disabilities Waiver
Community First Choice (CFC) Personal Assistance Services (PAS)/Habilitation (HAB) and In-Home Respite
(Agency and CDS)
1915(c) Home and Community-based Services Waiver
CFC PAS/HAB, In-Home Respite, and
Day Habilitation - provided in the home (Agency and CDS)
1915(c) Texas Home Living Waiver
1915(c) Youth Empowerment Services Waiver
In-Home Respite
(Agency) 1
1915(i) Home and Community Based Services (HCBS) Adult Mental Health
Supported Home Living-Habilitative Support and In-Home Respite
(Agency)1
1915(k) Community First Choice (including STAR Members who receive these services through the traditional Medicaid model)
CFC PAS and CFC HAB
(Agency, CDS and the Service Responsibility Option (SRO))
Personal Care Services provided under the Texas Health Steps Comprehensive Care Program (including STAR members who receive these services through traditional Medicaid model)
Personal Care Services
(Agency, CDS, and SRO)
STAR Health - MDCP Covered Services
In-Home Respite and Flexible Family Supports
[1] SRO/CDS Option is not available in the 1915(c) Youth Empowerment Services or the 1915(i) HCBS Adult Mental Health programs.

11. Texas Implementation Project
Pecan Valley and Burke were participating in Soft Launch but recently withdrew
Conducting Soft Launch/Evaluation Groups
Feedback Sessions
Broadcast #337
January 2019 to March 2019
Held biweekly
Focused on use of the current EVV system (DataLogic)
Feedback has influenced:
New business rules for other EVV Vendors
System design for EVV Aggregator & Portal
New and updated EVV policies
New and updated UMCM changes for MCOs
New and updated Program policies to require EVV

12. Texas Implementation Project
Pecan Valley and Burke were participating in Soft Launch but recently withdrew
Next Steps
Training – January to October 2019
Testing Systems - June to August 2019
Launching Systems to Existing Providers – September 1, 2019:
EVV Aggregator & Portal
Claims submission to TMHP for all claims with EVV relevant services
Standardized claims matching with results in the EVV Portal
Adding new Cures Act Providers – October to December 2019:
Selecting and onboarding with EVV Vendor of choice
Training with HHSC and TMHP
Matching claims to visit data (new Providers) starting - January 1, 2020
Cures Act Compliance for January 1, 2020

13. EVV Communications 21st Century Cures Act Website
Website updated on the 1st and 15th of the month;
Live webinar Q&A sessions on the 22 of each month
If the 22 is a weekend or holiday the live webinar will be held on the next normal business day.
January 22nd – 1pm-3pm
21st Century Cures Act Website
term-care-providers/resources/electronic-visit-verification/21st- century-cures-act
EVV Alerts via GovDelivery
EVV Toolkit
Monthly alerts (1st and 15th) and Q&A webinars (22nd), FAQs