Provider Alert! EVV Direction for FMSAs on CDS Employer Usage

Date: August 1, 2022

Attention: FMSA and Consumer Directed Services Employers

Effective date: September 1, 2022

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.

Call to action: The purpose of this communication is to inform Texas Children’s Health Plan (TCHP) financial management services agencies (FMSAs) and CDS employers of the direction being provided on CDS employer EVV usage.

Background information: In preparation for payers conducting Electronic Visit Verification (EVV) Usage Reviews for Consumer Directed Services (CDS) employers for dates of service on and after September 1, 2022, the Health and Human Services Commission (HHSC) published Information Letter No. 2022-40. This letter provides direction for financial management services agencies (FMSAs) on CDS employer EVV usage.

Information about the Information Letter:

• The letter includes two attachments with resources and information that FMSAs must provide to their CDS employers and designated representatives (DRs), as applicable.
• The letter also includes FMSA responsibilities related to CDS employer EVV Usage Reviews. This is to help make sure the minimum EVV Usage Score is met.
• CDS employers are monitored at the member level and each member who has selected the CDS option will receive an EVV Usage Score.

How this impacts providers: Reminder: EVV Usage Reviews Begin for CDS Employers on September 1, 2022

Payers will begin conducting EVV Usage Reviews for CDS employers for dates of service on or after September 1, 2022.

FMSAs must provide a copy of this notice available here to all their CDS employers by ten business days after the publication date of the attached notice to CDS employers with EVV Usage Scores below 40%.

This notice informs CDS employers that their current EVV Usage Score is below 40%. The CDS Employer Usage grace period will end August 31, 2022. Effective September 1, 2022, CDS employers will be expected to meet a minimum EVV Usage Score of 40% for the first fiscal year quarter, September 1, 2022, through November 30, 2022. The notice reminds CDS employers that their CDS employees must use an HHSC-approved clock in and clock out method to capture EVV visits in the EVV system.

HHSC will email each FMSA a list of CDS employers below the 40% EVV Usage Score. The email will be from EVVcompliance@hhs.texas.gov. FMSAs must provide a copy of the attached letter to the CDS employers identified by HHSC, within 10 business days from date of HHSC’s email.

Next steps for providers: CDS Employers should share this communication with their staff so that they are prepared for the EVV usage reviews.

If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.

For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.