2000, EVV Stakeholders

Revision 25-2, Effective Sept. 2, 2025

The following EVV stakeholders must meet all state and federal EVV requirements:

• Payers – HHSC and MCOs
• Texas Medicaid & Healthcare Partnership (TMHP)
• State provided EVV system vendor
• EVV proprietary system vendors
• EVV Proprietary System Operators (PSOs)
• Program providers delivering services under the agency option, including program providers approved as a PSO
• FMSAs, including FMSAs approved as a PSO
• Medicaid members and SRO participants
• CDS employers

2100 Payers

Revision 24-1; Effective Sept. 12, 2024

Payers pay Medicaid claims, administer the EVV program and enforce EVV requirements. In Texas, the payers are HHSC and the MCOs.

Payer responsibilities include:

• Following state and federal requirements when processing claims for EVV-required services
• Developing EVV policies, processes, and procedures
• Providing EVV policy training to program providers, FMSAs and CDS employers
• Conducting EVV compliance reviews of program providers, FMSAs and CDS employers

HHSC requires EVV for Medicaid personal care services authorized by the following HHSC programs:

• Long-term Care (LTC) Fee-for-Service (FFS)
• Acute Care FFS
• Managed Care

HHSC is the payer for LTC and acute care services administered by the state, known as FFS. TMHP makes acute care payments on behalf of HHSC.

LTC FFS

Acute Care FFS

MCOs are the payers for managed care services.

Managed Care

More information about managed care is on the HHSC managed care website.

2200 Texas Medicaid & Healthcare Partnership

Revision 25-1; Effective March 12, 2025

Texas Medicaid & Healthcare Partnership (TMHP), the state’s claims administrator, is responsible for the Medicaid Management Information System (MMIS) where the EVV Aggregator resides. TMHP is also responsible for the EVV Portal, the state provided EVV system vendor, the EVV proprietary system vendors and coordinates all data exchange for EVV systems.

TMHP responsibilities include:

• Processing claims for EVV services, including forwarding claims to MCOs
• Paying claims for Acute Care FFS on behalf of HHSC
• Managing the EVV Aggregator and EVV Portal
• Managing the state provided EVV system vendor on behalf of HHSC
• Training on the EVV Portal
• Overseeing the proprietary systems, including the approval and onboarding of new EVV proprietary system vendors

The TMHP EVV webpage has more information. Review and accept the terms and conditions to view the content.

2300 State Provided EVV System Vendor

Revision 25-2, Effective Sept. 2, 2025

The state provided EVV system vendors must:

• Adhere to all HHSC state provided EVV system vendor business rules for system operation and functionality
• Follow all EVV requirements described in:
  • The EVV Policy Handbook and stand-alone EVV policies HHSC publishes on the EVV webpage
  • Title 1 of the Texas Administrative Code (1 TAC), Part 1, Chapter 354, Subchapter O, Electronic Visit Verification
  • Texas Government Code Chapter 532, Subchapter F
• Support multiple clock in and clock out methods
• Provide EVV ongoing and annual system training
• Provide technical support

Refer to 4100 EVV System Selection.

2400 EVV Proprietary System Vendor

Revision 25-2; Effective Sept. 2, 2025

An EVV Proprietary System Vendor is an entity that develops and offers an EVV proprietary system for use by program providers and FMSAs approved to use the system as Proprietary System Operators (PSOs).

EVV proprietary system vendors must:

• Adhere to all HHSC EVV Business Rules for Proprietary Systems
• Follow all EVV requirements described in:
  • The EVV Policy Handbook and stand-alone EVV policies HHSC publishes on the EVV webpage
  • Title 1 of the Texas Administrative Code (1 TAC), Part 15, Chapter 354, Subchapter O, Electronic Visit Verification
  • Texas Government Code Chapter 532, Subchapter F
• Offer multiple clock in and clock out methods, including a mobile application
• Provide technical support for their EVV proprietary system
• Provide training support for PSOs that choose their system

2500 EVV Proprietary System Operator

Revision 26-1, Effective Jan. 30, 2026

An EVV Proprietary System Operator (PSO) is a program provider or FMSA approved to use an approved EVV Proprietary System. Note: A PSO is still required to comply with all program provider requirements and FMSAs. Refer to 2600 Program Provider and 2700 Financial Management Services Agency for more information on the requirements for program providers and FMSAs.

EVV PSOs must:

• Adhere to all HHSC EVV Business Rules for Proprietary Systems
• Follow all EVV requirements described in:
• The EVV Policy Handbook and stand-alone EVV policies HHSC publishes on the EVV webpage
• Title 1 of the Texas Administrative Code (1 TAC), Part 15, Chapter 354, Subchapter O, Electronic Visit Verification
• Texas Government Code Chapter 532, Subchapter F
• Support at least one approved clock in and clock out method, one must be the mobile application
• Provide EVV system training and technical support to their staff
• Make sure their chosen EVV Proprietary System Vendor complies with the requirements in 2400 EVV Proprietary System Vendor

Refer to 5000 EVV Proprietary System.

2600 Program Provider

Revision 25-2; Effective Sept. 2, 2025

A program provider is an entity that contracts with HHSC or an MCO to provide an EVV service.

Program providers must:

• Follow all EVV requirements described in:
  • The EVV Policy Handbook and stand-alone EVV policies HHSC publishes on the EVV webpage
  • Title 1 of the Texas Administrative Code (1 TAC), Part 15, Chapter 354, Subchapter O, Electronic Visit Verification
  • Texas Government Code Chapter 532, Subchapter F
• Adhere to policies and requirements of their Medicaid program
• Meet other applicable HHSC and MCO requirements
• Complete all required EVV training
• Use the EVV system
• Train service providers on the use of EVV
• Make sure service providers use the EVV system to clock in at the beginning of service delivery and clock out at the end of service delivery
• Manage program provider, service provider and member data within the EVV system

A program provider that has been approved as a proprietary system operator (PSO) must still comply with the program provider requirements.

2700 Financial Management Services Agency

Revision 25-2; Effective Sept. 2, 2025

A financial management services agency (FMSA) is an entity that contracts with HHSC or an MCO to provide financial management services to a CDS employer.

FMSAs must:

• Follow all EVV requirements described in:
  • The EVV Policy Handbook and stand-alone EVV policies HHSC publishes on the EVV webpage
  • Title 1 of the Texas Administrative Code (1 TAC), Part 15, Chapter 354, Subchapter O, Electronic Visit Verification
  • Texas Government Code Chapter 532, Subchapter F
• Adhere to policies and requirements of their Medicaid program
• Meet other applicable HHSC and MCO requirements
• Select an EVV system
• Assist the CDS employer complete and update Form 1722, Employer’s Selection for EVV Responsibilities, and enter selections into the EVV system
• Complete all required EVV training
• Use the EVV system
• Manage FMSA, CDS employers, member and service provider data within the EVV system

Refer to 17010 CDS Option Stakeholders.

An FMSA that has been approved as a proprietary system operator (PSO) must still comply with the FMSA requirements.

2800 Member

Revision 25-2; Effective Sept. 2, 2025

A member is a person eligible to receive Medicaid services that require the use of EVV.

Members must:

• Review and sign applicable program specific documents that describe a member’s rights and responsibilities
• Tell the program provider if a service provider asks the member to clock in or clock out of the EVV system

2900 CDS Employer

Revision 25-2; Effective Sept. 2, 2025

CDS employers must:

• Complete all required EVV training
• Train their CDS employees on the use of the EVV system
• Make sure CDS employees use the EVV system to clock in when services begin and clock out when services end
• Approve time worked
• Signing up for GovDelivery to receive the most current news and alerts related to EVV
• Follow all EVV requirements applicable to CDS employers described in:
  • The EVV Policy Handbook and stand-alone EVV policies HHSC publishes on the EVV webpage
  • Title 1 of the Texas Administrative Code (1 TAC), Part 15, Chapter 354, Subchapter O, Electronic Visit Verification
  • Texas Government Code Chapter 532, Subchapter F

Refer to 17000 EVV CDS Employer Policies.