Provider Alert! 90-Day Notice of EVV Compliance for Cures Act Personal Care Services Providers

Date: October 1, 2021

Attention: Financial Management Services Agencies and Consumer Directed Services employers

Effective Date: January 1, 2022

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to 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: Effective January 1, 2022, the payers, Health and Human Servcies commission (HHSC) and TCHP, will begin Electronic Visit Verification compliance reviews to ensure Cures Act Personal Care Services providers are in compliance with EVV requirements and policies. Cures Act Personal Care Services were required to use EVV by January 1, 2021 due to federal requirements and are listed on pages 2 and 3 of Personal Care Services Required to Use EVV (PDF).

Payers conduct EVV compliance reviews on a regular basis and may initiate contract or enforcement action for dates of service on or after January. 1, 2022 for program providers, Financial Management Service Agencies and Consumer Directed Services employers who do not meet any of the following EVV compliance requirements:

• EVV Landline Phone Verification: ensures valid phone type is used
• EVV-Required Free Text: ensures required free text is documented
• EVV Usage: ensures the minimum EVV Usage Score has been met
  • Note: The CDS employer EVV Usage review grace period has been extended to August 31, 2022. A notice will be provided prior to the end date of the grace period.

Payers will not start reviews until the EVV visit maintenance time frame is expired.

How this impacts providers: Before EVV compliance reviews begin, program providers, FMSAs and CDS employers should:

• Continue using the EVV system and
• Review compliance reports as a tool to monitor compliance.
  • For instructions on how to access and review reports in the EVV Portal, review TMHP’s EVV Job Aids found on their EVV Training webpage.
  • The EVV vendors, DataLogic and First Data, have instructions on how to access and review the EVV Landline Phone Verification report in their systems. The contact guides in the Resources section on the HHSC EVV webpage includes the vendors’ contact information.

Next steps for providers: EVV Compliance Reports

The following EVV compliance reports can be found in the EVV Portal:

• EVV Usage Report
• EVV Reason Code and Required Free Text Reports

The EVV Landline Phone Verification Report is available in the EVV system.

If you have any questions, please email TCHP’s EVV Workgroup at evvgroup@texaschildrens.org.

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