(a) Entities subject to this subchapter. The requirements
in this subchapter apply to a program provider, a consumer directed
services (CDS) employer, a financial management services agency (FMSA),
a service provider, a member, and a managed care organization (MCO)
unless otherwise specified in the text.
(b) Services subject to this subchapter. The use of
electronic visit verification (EVV) is required for all service delivery
options for the following services:
(1) personal attendant services provided in the Community
Attendant Services Program;
(2) personal attendant services provided in the Family
Care Program;
(3) personal attendant services provided in the Primary
Home Care Program;
(4) Community First Choice (CFC) services delivered
through the traditional Medicaid service model also referred to as
fee-for-service:
(A) Community First Choice Personal Assistance Services
(CFC PAS); and
(B) Community First Choice Habilitation (CFC HAB);
(5) personal care services (PCS) provided under the
Texas Health Steps Comprehensive Care Program;
(6) Community Living Assistance and Support Services
Program services:
(A) CFC PAS/HAB; and
(B) in-home respite;
(7) Deaf Blind with Multiple Disabilities Program services:
(A) CFC PAS/HAB; and
(B) in-home respite;
(8) Home and Community-Based Services (HCBS) Adult
Mental Health Program services:
(A) supported home living - habilitative support; and
(B) in-home respite;
(9) Home and Community-based Services Program services:
(A) CFC PAS/HAB;
(B) respite provided in a member's residence; and
(C) day habilitation provided in a member's residence;
(10) State of Texas Access Reform (STAR) Health Program
services:
(A) CFC PAS;
(B) CFC HAB;
(C) PCS; and
(D) Medically Dependent Children Program (MDCP) STAR
Health covered service:
(i) in-home respite; and
(ii) flexible family support;
(11) STAR Kids Program services:
(A) CFC PAS;
(B) CFC HAB;
(C) PCS; and
(D) MDCP STAR Kids covered service:
(i) in-home respite care; and
(ii) flexible family support;
(12) STAR+PLUS Program services:
(A) personal assistance services;
(B) CFC PAS; and
(C) CFC HAB;
(13) STAR+PLUS HCBS Program services:
(A) in-home respite care;
(B) protective supervision;
(C) personal assistance services;
(D) CFC PAS; and
(E) CFC HAB;
(14) STAR+PLUS Medicare-Medicaid Plan services:
(A) in-home respite care;
(B) protective supervision;
(C) personal assistance services;
(D) CFC PAS; and
(E) CFC HAB;
(15) Texas Home Living Program services:
(A) CFC PAS/HAB;
(B) respite provided in a member's residence; and
(C) day habilitation provided in a member's residence;
(16) in-home respite provided in the Youth Empowerment
Services Program; and
(17) any other service required by federal or state
mandates.
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