Date: July 19, 2024
Attention: STAR Kids Providers/Consumer Directed Services employers, and FMSA Providers
Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that in response to the recent severe weather, the Health and Human Services Commission (HHSC) is issuing the following guidance for Electronic Visit Verification (EVV) program providers, financial management services agencies (FMSAs) and Consumer Directed Services (CDS) employers.
All service delivery for an EVV-required service must be documented in the EVV system. If an EVV clock in and clock out method (home phone landline, mobile, or alternative device) was not available due to the severe weather, service providers and CDS employees must make best efforts to document service delivery visits according to program policies.
For visits which were not recorded using an EVV clock in and clock out method, program providers, CDS employers and FMSAs must:
- Create manual visits in the EVV system based on the program requirements, and ensure the visit is accepted into the EVV Aggregator/Portal within 95 calendar days from the date of the visit.
- Keep all supporting service delivery documentation available as required by program policy.
As a reminder, claims matching for all EVV required services began April 1, 2024. If a claim is submitted for an EVV required service, a valid EVV visit must be on file.
EVV Reason Code
See the following EVV reason code example when performing visit maintenance on visits affected by the hurricane (including creating manual visits):
Reason Code: Disaster
Number: 130
Description: B – Hurricane
EVV Compliance Impacts
Program providers, CDS employers and FMSAs are currently in a grace period for EVV usage and landline reviews. This means that anytime a manual visit is entered into the EVV system, it will affect your EVV Usage Score. Per the HHSC EVV Policy Handbook, Payers must perform due diligence before taking any enforcement action. Manual entries with a reason code for natural disaster lowering a stakeholder’s overall EVV Usage Score would be considered before taking any enforcement action during a non-grace period.
Contact EVV with questions.
Next step for Providers: Providers should share this update with their staff.
If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.
For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.
