|(a) Use of an EVV System.
(1) A program provider, consumer directed services
(CDS) employer, and financial management services agency (FMSA) must
ensure an electronic visit verification (EVV) vendor system or an
HHSC-approved EVV proprietary system is used to electronically document
the delivery of a service described in §354.4005 of this subchapter
(relating to Applicability).
(2) A program provider, CDS employer, and FMSA must:
(A) ensure that each EVV visit transaction contains
the following data elements, including identifying information, as
required by HHSC, for:
(i) the type of service provided;
(ii) the name of the member who received the service;
(iii) the name of the service provider who provided
(iv) the date of the service;
(v) the time the service began and ended;
(vi) the location, including the address, at which
the service was provided; and
(vii) other information HHSC determines necessary to
ensure the accurate payment of a claim for services, as described
in the EVV Policy Handbook;
(B) ensure the accuracy of the data elements on each
EVV visit transaction; and
(C) comply with all HHSC requirements for correcting
or noting an inaccurate data element.
(b) Access to an EVV System.
(1) A program provider must allow HHSC or a managed
care organization (MCO), with which they contract, immediate, direct,
on-site access to the EVV system the program provider uses.
(2) An FMSA must allow HHSC or an MCO with whom the
member is enrolled and with whom the FMSA contracts, immediate, direct,
on-site access to the EVV system the FMSA uses.
(c) Access to Documentation.
(1) A program provider and an FMSA must ensure that
HHSC can review EVV system documentation or obtain a copy of that
documentation at no charge to HHSC.
(2) A program provider and an FMSA must ensure an MCO,
with which a claim for payment for a service is filed, can review
EVV system documentation related to the claim or obtain a copy of
that documentation at no charge to the MCO.