| (a) A program provider or FMSA must use one of the
following EVV systems to electronically document the provision of
a service described in §354.4005 or §354.4006 of this subchapter
(relating to Personal Care Services that Require the Use of EVV and
Home Health Care Services that Require the use of EVV):
(1) an EVV vendor system; or
(2) an EVV proprietary system.
(b) A CDS employer must use the EVV system selected
by their FMSA.
(c) Except as provided in subsection (d) of this section,
a program provider, an FMSA, and a CDS employer must ensure that a
service provider uses an EVV system to electronically document the
provision of a service described in §354.4005 or §354.4006
of this subchapter as described in the EVV Policy Handbook.
(d) If a service provider fails to use an EVV system
to document the provision of a service described in §354.4005
or §354.4006 of this subchapter or if a service provider cannot
use an EVV system because the EVV system is unavailable, a program
provider, FMSA or a CDS employer must:
(1) ensure the data elements required by §354.4009(a)(1)
of this subchapter (relating to EVV Visit Transaction and EVV Claim)
are accurate; and
(2) complete visit maintenance.
(e) If a program provider or an FMSA does not comply
with subsections (a), (c), or (d) of this section, HHSC or an MCO
may do one or more of the following:
(1) deny payment for a service;
(2) take enforcement action including:
(A) requiring a program provider or FMSA to complete
a corrective action plan; or
(B) propose to terminate the contract of the program
provider or FMSA.
(f) If a CDS employer does not comply with subsections
(b), (c), or (d) of this section, HHSC or an MCO may:
(1) require the CDS employer to complete a corrective
action plan; or
(2) propose to terminate the member's participation
in the CDS option.
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