21st Century Cures Act and Electronic Visit Verification Implementation Dates and Milestones
The 21st Century Cures Act Section 12006 (Cures Act) is a federal law requiring Electronic Visit Verification (EVV) for all Medicaid home health care services (HHCS); including services delivered through the consumer directed services option and the service responsibility option.
Texas Health and Human Services Commission (HHSC) is implementing EVV in the following two phases:
- Effective January 1, 2021, EVV is required for Medicaid personal care services (PCS)
- Effective January 1, 2024, EVV is required for Medicaid home health care services (HHCS)
Visit the Texas Health and Human Services Commission (HHSC) EVV webpage for detailed information about the Cures Act and how it affects providers in Texas.
EVV Home Health Care Services PRACTICE PERIOD: Oct. 1, 2023 – Dec. 31, 2023
The EVV home health care services practice period allows program providers and FMSAs required to use EVV for home health care services by Jan. 1, 2024, to practice using the EVV system, the EVV Portal, and submit EVV claims before the implementation date of January 1, 2024. Service providers will practice clocking in and clocking out and the visit data is transmitted to the EVV system. EVV visit transactions are exported to the EVV Aggregator for informational claims matching. This practice period does not apply to personal care services.
Note: CDS employers can practice using the EVV system selected by their FMSAs.
During the practice period, EVV claims will be paid by the payers even if the EVV visit transactions don’t match the EVV claims. The EVV claims will receive EVV07 (claims matching bypass), however, will still receive the informational EVV claims match result (EVV01-EVV06). But starting Jan. 1, 2024, payers will not pay EVV claims that do not match EVV visit transactions.
JANUARY 1, 2024
EVV CLAIMS MATCHING WITH DENIALS BEGINS FOR HOME HEALTH CARE SERVICES (HHCS) CLAIMS
When an HHCS EVV claim is submitted without a matching EVV visit transaction, the EVV claim will be denied. This applies to all program providers and FMSAs required to use an EVV system. Program providers and FMSAs will be able to view EVV claim match results on the EVV Portal.
EVV Compliance Grace Period: July 1, 2023, through December 31, 2023
HHSC has implemented an EVV Compliance Grace Period for EVV Usage and Home Phone Landline from July 1, 2023, through December 31, 2023, for all program providers, FMSAs, and CDS employers. During the grace period, HHSC and the Managed Care Organizations will not take enforcement action against program providers, FMSAs, and CDS employers who do not meet EVV compliance requirements for EVV Usage and home phone landline reviews.