Section 354.4017 - Process to Request Approval of a Proposed EVV Proprietary System and Additional Requirements for a PSO(a) This section applies to a program provider or FMSA seeking HHSC's approval of a proposed EVV proprietary system. To request HHSC's approval of a proposed EVV proprietary system, a program provider or FMSA must comply with the onboarding process described in the EVV Policy Handbook, which includes: (1) completing and submitting the EVV Proprietary System Request Form; and(2) participating in an operational readiness review session.(b) HHSC approves a proposed EVV proprietary system if a program provider or FMSA: (1) demonstrates that the proposed EVV proprietary system complies with: (A) the EVV Policy Handbook(B) the EVV Business Rules for Proprietary Systems; and(C) state and federal laws governing EVV; and(2) successfully completes the operational readiness review by receiving a score of 100% in the following methods, as described in the EVV Policy Handbook: (D) trading partner testing.(c) A PSO must: (1) ensure the EVV proprietary system complies with the HHSC EVV Policy Handbook, the EVV Business Rules for Proprietary Systems, and state and federal laws governing EVV;(2) assume responsibility for the design, development, operation, and performance of the EVV proprietary system;(3) cover all costs to develop, implement, operate, and maintain the EVV proprietary system;(4) ensure the accuracy of EVV data collected, stored, and reported by the EVV proprietary system;(5) assume all liability and risk for the use of the EVV proprietary system;(6) maintain all data generated by the EVV proprietary system to demonstrate compliance with this subchapter and for general business purposes;(7) develop training materials on the proprietary system and train HHSC staff and MCO staff;(8) provide access to all HHSC-approved clock in and clock out methods offered by the PSO to a service provider at no cost to a member, HHSC, an MCO, or HHSC's designated contractor;(9) ensure the functionality and accuracy of all clock in and clock out methods provided to a service provider;(10) comply with the process in the HHSC EVV Policy Handbook if transferring EVV proprietary systems; and(11) notify HHSC, in writing, if: (A) the EVV proprietary system is not in compliance with the HHSC EVV Policy Handbook, the EVV Business Rules for Proprietary Systems, and state and federal laws governing EVV; or(B) if the PSO plans to make significant changes to the EVV system.(d) HHSC may, at its discretion, audit an EVV proprietary system. Such audit may be conducted by a contractor of HHSC.(e) If HHSC determines that a PSO is not in compliance with subsection (c) of this section, HHSC may, in accordance with the HHSC EVV Policy Handbook: (1) require the PSO to correct the non-compliance within a time frame specified by HHSC;(2) reject EVV visit transactions from the proprietary system until HHSC determines the non-compliance is corrected;(3) cancel the use of the EVV proprietary system if:(A) the PSO fails to correct the non-compliance within the time frame specified by HHSC; or(B) the PSO does not respond to a written communication from HHSC about the non-compliance within the time frame specified by HHSC; and(4) cancel the use of an EVV proprietary system without giving the PSO the opportunity to correct the non-compliance: (A) if the non-compliance is egregious, as determined by HHSC; or(B) because of a substantiated allegation of fraud, waste, or abuse by the Office of Inspector General.1 Tex. Admin. Code § 354.4017
Adopted by Texas Register, Volume 48, Number 49, December 8, 2023, TexReg 7171, eff. 1/1/2024