Texas Medicaid and Healthcare Partnership confirmed there was a system defect that calculated incomplete Electronic Visit Verification Usage Scores. The following reports were excluding “Updated” visit transactions:
- EVV Usage Report.
- EVV Consumer Directed Services Employer Usage Report.
Effective Aug. 4, TMHP corrected this issue, and changes have been made to both reports.
Managed care organizations are aware of this defect and correction. MCOs will use the corrected reports for past EVV Usage Reviews and will contact program providers with any updates on previous compliance actions.
HHSC did not take any EVV Compliance action during the EVV Usage Report defect.
As a reminder, the CDS Employer Usage grace period will end Aug. 31. Effective Sept. 1, CDS employers will be expected to meet a minimum EVV Usage Score of 40% for the first fiscal year quarter, Sept. 1 through Nov. 30.
Payers will start the reviews after the 95-day visit maintenance time frame expires based on the last day of quarter. Refer to the table below for more information.
| Fiscal Year | Quarter | Service Delivery Dates | Minimum EVV Usage Score for CDS Employers |
|---|---|---|---|
| FY 23 | Q1 | 9/1/2022–11/30/2022 | 40% |
| FY 23 | Q2 | 12/1/2022–2/28/2023 | 60% |
| FY 23 | Q3 | 3/1/2023–Ongoing | 80% |