TX HHS Form 1722. Employer's Selection for Electronic Visit Verification Responsibilities

The Texas Health and Human Services (HHS) requires the use of Electronic Visit Verification (EVV) for all Medicaid personal care services requiring an in-home visit by a service provider. The EVV system ensures that services are accurately documented and verified through electronic documentation.

This form, TX HHS Form 1722, is used by employers to select their responsibilities for EVV and train their employees on the use of the EVV system. Employers must ensure that their employees clock in and out of the EVV system using an approved electronic verification method, such as a mobile application or landline phone. The form also outlines visit maintenance procedures to correct any errors or inaccuracies in the EVV system.

The purpose of this form is to facilitate compliance with federal regulations and ensure accurate adjudication of Medicaid claims. By completing this form, employers acknowledge their understanding of their responsibilities for using EVV and agree to complete required trainings prior to accessing the EVV system. The Texas HHS issues this form as part of its efforts to implement the 21st Century Cures Act and improve the efficiency and accuracy of Medicaid services.