HHSC Electronic Visit Verification Overview April 2019

What is EVV? EVV is a computer-based system that electronically: Verifies that service visits occur; and Documents the date and time service delivery begins and ends.

How does EVV Work? When an attendant provides services to a member in the home or the community, the attendant will use one of three approved EVV time recording methods to clock in when service delivery begins and clock out when service delivery ends. Mobile Application Alternative Device Member’s Home Phone Landline

What data is collected? EVV electronically documents the following visit data: Member receiving services Attendant providing services Location of service delivery Date of service delivery Time the attendant begins and ends service delivery

How is EVV data used? EVV visits are required for EVV claim payment. Claims with EVV relevant services will be matched against visit data collected at a new system called the EVV Aggregator. Claims that do not match the visit data will be denied by the payer of that claim (Managed Care Organization or TMHP). The following critical data elements will be matched: National Provider ID (NPI) or Atypical Provider ID (API) Medicaid ID of individual receiving services Date of service Units of service Type of service as identified by billing code

EVV Process Flow (Sept. 1, 2019) * EVV Portal can be accessed by Providers to view their EVV Visit Data for billing and Claims Matching results.

EVV Process Flow (January 1, 2020) * EVV Portal can be accessed by Providers to view their EVV Visit Data for billing and Claims Matching results.

21st Century Cures Act Section 12006 of the 21st Century Cures Act (Cures Act), is a federal law requiring all states to use EVV for Medicaid Personal Care Services and Home Health Care Services; including services delivered through the Consumer Directed Services (CDS) option. States must implement EVV or risk a loss of federal Medicaid matching dollars. Personal Care Services must start by Jan. 1, 2020 Home Health Care Services must start Jan. 1, 2023

Current Services Requiring EVV 21st Century Cures Act Impact for January 1, 2020 – SRO/CDS The following HHSC programs and services are currently required to use EVV. Program Current Services Requiring EVV 1915(c) Community Living Assistance and Support Services (CLASS) Waiver CFC PAS/HAB and In-Home Respite Community Attendant Services Personal Assistance Services (PAS) Family Care PAS Primary Home Care STAR Health CFC PAS, CFC HAB, and Personal Care Services (PCS) STAR Kids CFC PAS, CFC HAB, and PCS STAR Kids - MDCP Covered Services In-Home Respite and Flexible Family Supports STAR+PLUS CFC PAS, CFC HAB, and PAS STAR+PLUS HCBS PAS, In-Home Respite, and Protective Supervision Currently, EVV is optional for individuals using the SRO/CDS option; however, with the passage of the 21st Century Cures Act, the use of EVV will be required when using the SRO/CDS option

21st Century Cures Act New Program Services for January 1, 2020 Potentially Impacted: YES Waiver – Community Living Supports Home and Community-Based Services – Adult Mental Health – HCBS-AMH New Program Services for January 1, 2020 Program   Services and Service Delivery Options Requiring EVV (January 1, 2020) 1915(c) Deaf Blind with Multiple Disabilities Waiver Community First Choice (CFC) Personal Assistance Services (PAS)/Habilitation (HAB) and In-Home Respite (Agency and CDS) 1915(c) Home and Community-based Services Waiver CFC PAS/HAB, In-Home Respite, and Day Habilitation - provided in the home (Agency and CDS) 1915(c) Texas Home Living Waiver 1915(c) Youth Empowerment Services Waiver In-Home Respite (Agency) 1 1915(i) Home and Community Based Services (HCBS) Adult Mental Health Supported Home Living-Habilitative Support and In-Home Respite (Agency)1 1915(k) Community First Choice (including STAR Members who receive these services through the traditional Medicaid model) CFC PAS and CFC HAB (Agency, CDS and the Service Responsibility Option (SRO)) Personal Care Services provided under the Texas Health Steps Comprehensive Care Program (including STAR members who receive these services through traditional Medicaid model) Personal Care Services (Agency, CDS, and SRO) STAR Health - MDCP Covered Services In-Home Respite and Flexible Family Supports [1] SRO/CDS Option is not available in the 1915(c) Youth Empowerment Services or the 1915(i) HCBS Adult Mental Health programs.

Texas Implementation Project Pecan Valley and Burke were participating in Soft Launch but recently withdrew Conducting Soft Launch/Evaluation Groups Feedback Sessions Broadcast #337 January 2019 to March 2019 Held biweekly Focused on use of the current EVV system (DataLogic) Feedback has influenced: New business rules for other EVV Vendors System design for EVV Aggregator & Portal New and updated EVV policies New and updated UMCM changes for MCOs New and updated Program policies to require EVV

Texas Implementation Project Pecan Valley and Burke were participating in Soft Launch but recently withdrew Next Steps Training – January to October 2019 Testing Systems - June to August 2019 Launching Systems to Existing Providers – September 1, 2019: EVV Aggregator & Portal Claims submission to TMHP for all claims with EVV relevant services Standardized claims matching with results in the EVV Portal Adding new Cures Act Providers – October to December 2019: Selecting and onboarding with EVV Vendor of choice Training with HHSC and TMHP Matching claims to visit data (new Providers) starting - January 1, 2020 Cures Act Compliance for January 1, 2020

EVV Communications 21st Century Cures Act Website Website updated on the 1st and 15th of the month; Live webinar Q&A sessions on the 22 of each month If the 22 is a weekend or holiday the live webinar will be held on the next normal business day. January 22nd – 1pm-3pm 21st Century Cures Act Website https://hhs.texas.gov/doing-business-hhs/provider-portals/long- term-care-providers/resources/electronic-visit-verification/21st- century-cures-act EVV Alerts via GovDelivery https://service.govdelivery.com/accounts/TXHHSC/subscriber/new EVV Toolkit Monthly alerts (1st and 15th) and Q&A webinars (22nd), FAQs Electronic_Visit_Verification@hhsc.state.tx.us.