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Payers conduct EVV compliance reviews to ensure program providers, Consumer Directed Services (CDS) employers, and financial management services agencies (FMSAs) are in compliance with EVV requirements and policies.
Personal Care Services (PCS)
As stated in the EVV notice posted on July 17, HHSC implemented a compliance grace period for EVV usage and home phone landline reviews from July 1 to Dec. 31, 2023, for program providers, FMSAs and CDS employers.
This will allow for program providers and FMSAs who are onboarding with HHAeXchange, or as a Proprietary System Operator (PSO) to focus on transitioning efforts.
Payers will continue to conduct EVV Compliance reviews and send compliance notifications, however HHSC and Managed Care Organizations (MCOs) will not take enforcement actions against program providers, FMSAs, or CDS employers who do not meet the compliance requirements during the grace period.
As a reminder, effective Sept. 1, 2021, HHSC discontinued the Misuse of Reason Code policy and compliance reviews for misuse of reason codes.
Home Health Care Services (HHCS)
EVV will be implemented for Medicaid HHCS on Jan. 1, 2024. HHSC will provide an EVV usage and home phone landline review compliance grace period for visits with dates of service between Jan. 1, 2024, and Dec. 31, 2024.
During the grace period, HHCS program providers, FMSAs and CDS employers should monitor the compliance reports monthly, at a minimum, in the EVV Portal and perform the following:
- Use the EVV system as required.
- Complete all required visit maintenance before billing.
- Train or re-train service providers on clock in and clock out methods.
- Ask questions.
Payers will continue to conduct EVV Compliance reviews and send compliance notifications, however HHSC and Managed Care Organizations (MCOs) will not take enforcement actions against program providers, FMSAs, or CDS employers who do not meet the compliance requirements during the grace period.
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