Revision Notice 22-3; Effective June 1, 2022

This section provides important EVV policies and identifies sections in the EVV Policy Handbook for CDS employers. CDS employers must read 16000 EVV CDS Employer Policies and the EVV Policy Handbook sections identified throughout this section to review all EVV policies relevant to CDS employers. 

EVV CDS employer policies provide EVV standards and policy requirements that CDS employers and Medicaid members who selected the CDS option must follow if receiving a service required to use EVV.

EVV requirements apply to programs and services identified in HHSC TAC Title 1, Part 15, Chapter 354, Subchapter O, Rule Section 354.4005, Applicability. They are listed in the Programs and Services Required to Use EVV table located on the EVV webpage.

For EVV services provided on or after Jan. 1, 2021, CDS employers must ensure CDS employees clock in and clock out of the EVV system. Refer to 7000, Clock In and Clock Out Methods, for more information.

CDS employers must use the EVV system selected by their FMSA. Contact your FMSA to determine which EVV system your FMSA uses. 

If CDS employees do not use the EVV system, or if CDS employers do not comply with EVV requirements:

  • CDS employees may experience a delay in payment or inaccurate payments 
  • CDS employers must take more training
  • An FMSA may require CDS employers to complete a corrective action plan in accordance with TAC 40, Part 1, Chapter 41, Subchapter B, Rule Section 41.221 
  • CDS employers may be subject to removal from the CDS option
  • EVV claims payments without an accepted EVV visit transaction may be denied or recouped. 

Refer to 10000 EVV Compliance Reviews and 15000 Fraud, Waste and Abuse for more information. 

To avoid these consequences, contact your FMSA immediately. Begin using the EVV system as soon as possible. 

CDS employers must complete Form 1722, Employer’s Selection for Electronic Visit Verification Responsibilities to select how they will participate in EVV. All CDS employers, regardless of what option they select on the form, must:

  • Ensure CDS employees use the EVV system to clock in when EVV services begin and clock out when EVV services end. 
  • Approve CDS employee time worked in a timely manner.

CDS employers must continue to follow program rules regarding documentation requirements. EVV does not change applicable federal and state laws related to documentation requirements. FMSAs, CDS employers and CDS employees must comply with applicable federal and state laws related to confidentiality of a member’s information.

16010 CDS Option Stakeholders

Revision Notice 22-3; Effective June 1, 2022

The following are stakeholders in the CDS option and must meet all state and federal EVV requirements.

The FMSA contracts with HHSC or an MCO (payer) to provide financial management services to CDS employers.

The FMSA is responsible for:

  • Payroll and budget management
  • Selecting an EVV system
  • Adding and maintaining member, CDS employer and CDS employee information into the EVV system
  • Adding and maintaining member service authorizations into the EVV system
  • Creating the username and temporary password for CDS employers
  • Creating the username and temporary password for CDS employees 
  • Assisting the CDS employer with completing, and updating Form 1722, Employer’s Selection for EVV Responsibilities and entering selections into the EVV system
  • Training CDS employers on EVV policy 
    • The CDS employer also has the option to take EVV policy training with their payer
  • Helping CDS employers with questions related to EVV policy and process
  • Confirming approved time worked in the EVV system to ensure the services and hours were authorized

The CDS Employer is a member or legally authorized representative (LAR) responsible for hiring and retaining a service provider who delivers a Medicaid service to a member.

CDS employers are responsible for:

  • Completing all required EVV training.
  • Training CDS employees on the use of the EVV system.
  • Ensuring CDS employees use the EVV system to clock in when services begin and clock out when services end.
  • Approving time worked.
  • Signing up for GovDelivery to receive the most current news and alerts related to EVV

A Designated Representative (DR) is a person designated by the CDS employer to support or assist with meeting CDS employer responsibilities.

CDS employers can appoint a DR to assist or to perform EVV responsibilities in the CDS option using CDS Form 1720, Appointment of a Designated Representative. However, CDS employers still retain responsibility for CDS requirements.

CDS employers will specify which EVV tasks the DR will assist with or handle. Tasks might include approving CDS employee time worked or training CDS employees. CDS employers are responsible for actions taken by the DR.

The Legally Authorized Representative (LAR) is a person authorized by law to act on behalf of a parent, guardian or managing conservator of a minor, or the guardian of an adult.

The CDS Employee is a person who provides Medicaid services and is employed or contracted by a CDS employer.

The member is a person receiving Medicaid services.

Members are responsible for:

  • Reviewing and signing the form EVV Responsibilities and Additional Information.
  • Notifying their FMSA if a CDS employee asks the member to clock in or clock out of the EVV system.

16020 CDS Employer Steps Prior to Using an EVV System

Revision Notice 22-3; Effective June 1, 2022

CDS employers must complete the following steps before using an EVV system:

Step 1: Complete Form 1722, Employer’s Selection for EVV Responsibilities with FMSA assistance.

Step 2: Complete all required EVV trainings (Refer to 4230 EVV Training Requirements for CDS Employers):

  • EVV System
  • EVV Policy

Step 3: Train CDS employees on the clock in and clock out methods. (Refer to 4240 Training Requirements for Service Providers and CDS Employees)

Form 1722, Employer’s Selection for EVV Responsibilities

With assistance from the FMSA, CDS employers must complete this form by choosing the appropriate option for using the EVV system.

CDS employers may choose to have the DR assist with EVV responsibilities described on Form 1722, Employer’s Selection for EVV Responsibilities, if the CDS employer appoints a DR. The CDS employer is responsible for any actions taken by the DR and must ensure that the DR follows all privacy and security protocols, including when the DR accesses EVV data.

CDS employers who selected Option 1 (Option 1 CDS employer) on Form 1722, Employer’s Selection for Electronic Visit Verification Responsibilities must:

  • Ensure they have access to the EVV system and can perform EVV responsibilities.
  • Ensure CDS employees use the EVV system to clock in when EVV services begin and clock out when EVV services end.
  • Complete visit maintenance in the EVV system within the visit maintenance time frame.
  • Approve CDS employee time worked in the EVV system in a timely manner.

CDS employers who selected Option 2 (Option 2 CDS employer) on Form 1722, Employer’s Selection for Electronic Visit Verification Responsibilities must:

  • Ensure CDS employees use the EVV system to clock in when EVV services begin and clock out when EVV services end.
  • Approve CDS employee time worked in the EVV system in a timely manner.

CDS employers who selected Option 3 (Option 3 CDS employer) on Form 1722, Employer’s Selection for Electronic Visit Verification Responsibilities must:

  • Ensure CDS employees use the EVV system to clock in when EVV services begin and clock out when EVV services end.
  • Approve CDS employee time worked using the method the FMSA and CDS employer have agreed to in a timely manner.
    • Refer to program policy, CDS policy or the FMSA for more information.

If time worked is not captured in the EVV system, Medicaid cannot reimburse the FMSA for payroll. CDS employees may experience a delay in payment.

CDS employers must provide Form 1722, Employer’s Selection for EVV Responsibilities, to the FMSA.

If the CDS employer does not complete and provide Form 1722, Employer’s Selection for EVV Responsibilities to the FMSA before the member starts receiving EVV services, the FMSA will select Option 3 when creating the CDS employer’s account in the EVV system. CDS employers can request a change by completing a form and providing it to the FMSA.

Refer to Form 1722, Employer's Selection for Electronic Visit Verification Responsibilities for more information.

Required Training for CDS Employers

EVV Policy Handbook 4200 EVV Training requires CDS employers, or the appointed DR, to complete all required EVV training prior to using an EVV system for the first time and yearly.

Refer to 4230 EVV Training Requirements for CDS Employers for more information.

CDS employers can access HHSC EVV Training Requirements Checklist to track training requirements and completion of requirements. The checklist is available on the EVV Training Resources webpage.

CDS Employer Training Responsibilities

CDS employers are responsible for providing Clock In and Clock Out Methods training to CDS employees.

CDS employers must use Form 1732, Management and Training of Service Provider to keep up-to-date training records of CDS employee training completions. CDS employers must provide Form 1732 to the FMSA.

Refer to 4240 Training Requirements for Service Providers and CDS Employees for more information.

System Access for the CDS Employer

The FMSA is responsible for creating a username and temporary password in the EVV system for CDS employers depending on the option selected on Form 1722, Employer’s Selection for EVV Responsibilities:

  • Option 1: As needed for EVV system training, completing visit maintenance and approving time worked in the EVV system.
  • Option 2: As needed for EVV system training and approving time worked in the EVV system.
  • Option 3: As needed for EVV system training overview. Check with your FMSA to request view or read only access.

The EVV system or the FMSA will send CDS employers a username and the temporary password.

If the CDS employer is not the member, the FMSA will include the CDS employer’s information in the member profile and provide the username and temporary password to the CDS employer.

If the member has a DR, both the CDS employer and the DR will each have a unique username and temporary password.

CDS employers will use the username and temporary password to log in to the EVV system and change the temporary password.

The FMSA can only see the CDS employer’s username and email address in the EVV system. However, both the FMSA and the CDS employer can change the CDS employer’s password.

If the CDS employer does not receive a username and temporary password for any reason, contact the FMSA.

System Access for the CDS Employee

The FMSA is responsible for creating a username and temporary password for the CDS employee.

The FMSA or the CDS employer provides the username and temporary password to the CDS employee. CDS employers must contact the FMSA to determine who will provide the CDS employee the username or temporary password.

If the CDS employee does not receive a username and temporary password for any reason, contact the FMSA or the CDS employer.

Information Updates

CDS employers are responsible for ensuring payers and the FMSA have the most up to date information in the EVV system.

CDS employers must communicate to the FMSA if any of the following information changes:

  • Payer(s)
  • FMSA
  • Member’s address
  • Member’s home phone landline number, if applicable
  • Member’s and CDS Employer’s contact information
  • CDS employees

Schedules

EVV policy does not require the entry of schedules into the EVV system. Service delivery can occur with or without a schedule.

For members in the CDS option, schedules are optional to enter in the EVV system.

Some Medicaid programs require the use of a schedule for service delivery. FMSAs and CDS employers must follow the member’s program requirements to determine if schedules are required in the EVV system.

If the CDS employer wants to use schedules in the EVV system or the program requires a schedule, CDS employers must work with their FMSA to determine how schedules will be entered.

Refer to 4600 Schedules for more information.

16030 CDS Employer(s) Using an EVV System

Revision Notice 22-3; Effective June 1, 2022

Once CDS employers have completed Steps 1 -3 in 16020 CDS Employer Steps Prior to Using an EVV System, they can use the EVV system.

The following steps explain when to use the EVV system and required actions for CDS employers.

Step 4: The CDS employer must ensure the CDS employee uses an approved clock in and clock out method to:

  • Clock in at the beginning of service delivery.
  • Clock out at the end of service delivery.

Step 5: Option 1 CDS employers, or an FMSA on behalf of Option 2 and Option 3 CDS employers, must complete visit maintenance to:

  • Correct any exceptions or critical errors.
  • Adjust bill hours, if needed.
  • Add Reason Codes as required.
  • Enter manual EVV visits, if necessary.

Step 6: CDS employers must review and approve time worked after visit maintenance is complete.

  • Option 1 and Option 2 CDS employers will approve time worked using the EVV system.
  • Option 3 CDS employers will approve time worked using the method the FMSA and CDS employer have agreed to in a timely manner.

Visit Maintenance

Visit maintenance is the process used by the FMSA or CDS employer to correct the identification and visit data in the EVV system to accurately reflect the delivery of service.

Option 1 CDS employers must complete visit maintenance using the EVV system and must refer to section 8000 Visit Maintenance for detailed EVV policy requirements.

Option 1 CDS employers must:

  • Verify the EVV system captured data correctly.
  • Complete visit maintenance if there are exceptions or critical errors on an EVV visit transaction.
    • Use the most appropriate EVV Reason Code Number(s), EVV Reason Code Description(s) and free text, if applicable. Refer to 9000 EVV Reason Code for more information.
  • Enter manual EVV visits, if necessary.

Option 2 and Option 3 CDS employers elected to have their FMSA complete visit maintenance. Option 2 and Option 3 CDS employers must work with their FMSA to provide any necessary information for the FMSA to complete visit maintenance in a timely manner.

Approving Time Worked

After visit maintenance is complete and the EVV visit transaction accurately reflects time worked, CDS employers must approve time worked.

Option 1 CDS employers must verify the EVV system captured data correctly and complete visit maintenance before using the EVV system to approve time worked.

Option 2 CDS employers must work with their FMSA to ensure all required data elements are correct and visit maintenance is complete before Option 2 CDS employers approve time worked using the EVV system.

Option 3 CDS employers must review and approve time worked using the method the FMSA and CDS employer have agreed to in a timely manner.

Failure to approve CDS employee time worked in a timely manner may result in:

  • CDS employees experiencing a delay in payment or inaccurate payments.
  • CDS employers taking additional required training.

16040 Failure to Use an EVV System in the CDS Option

Revision Notice 22-3; Effective June 1, 2022

CDS employers:

  • Must ensure an approved EVV system is used to document the delivery of EVV-required services.
  • Are responsible for ensuring CDS employees use the EVV system to clock in when services begin and clock out when services end.

If the CDS employee does not use the EVV system to clock in or clock out, for any reason, they must document service delivery information and submit the documentation to the FMSA or CDS employer.

Option 1 CDS employers must manually enter the visit into the EVV system and keep all service delivery documentation.

Option 2 and Option 3 CDS employers must provide service delivery documentation to the FMSA to ensure visits are manually entered into the EVV system by the FMSA. The FMSA or CDS employer must keep service delivery documentation.

Refer to 1400 Failure to use an EVV System, 7000 Clock In and Clock Out Methods and 11000 Usage for more information.

16050 CDS EVV Compliance

Revision Notice 22-3; Effective June 1, 2022

CDS employers:

  • Are responsible for meeting compliance requirements for EVV Usage and EVV Landline Phone Verification.
  • Have access to system standard reports in the EVV system and must monitor compliance reports monthly, at a minimum.

Refer to 10000 EVV Compliance Reviews, 11000 Usage and 13020 EVV System Standard Reports for more information.

16060 CDS Bonuses and Overtime

Revision Notice 22-3; Effective June 1, 2022

EVV does not change, impact or track:

  • Bonuses in the CDS option
  • Overtime in the CDS option

Follow your FMSA’s process for bonuses and overtime.

16070 CDS Complaints

Revision Notice 22-4; Effective Sept. 1, 2022

CDS employers who have complaints may contact:

CDS employers can find the EVV Contact Information Guide for CDS Employers under resources on the EVV Consumer Directed Services Option webpage.