SECTION 2. DHS 10.41 (2) is amended to read:
Services. Services provided under the family care benefit shall be determined through individual assessment of enrollee needs and values and detailed in an individual service plan unique to each enrollee. As appropriate to its target population and as specified in the department's contract, each CMO shall have available at least the services and support items covered under the home and community-based waivers under 42 USC 1396n (c) and ss. 46.275, 46.277 and 46.278, Stats., the long-term support community options program under s. 46.27, Stats., and specified services and support items under the state's plan for medical assistance. In addition, a CMO may provide other services that substitute for or augment the specified services if these services are cost-effective and meet the needs of enrollees as identified through the individual assessment and service plan. When providing applicable services, CMOs shall comply with EVV requirements. SECTION 3. DHS 101.03 (51p) and (51t) are created to read:
DHS 101.03 (51p) "Electronic visit verification" or “EVV” means, with respect to personal care services or home health care services as defined and required in Section 12006 of the 21st Century Cures Act, 42 USC 1396b (l), a system under which in-home visits conducted as part of such services are electronically verified. (51t) “EVV record” means the information or data related to an electronically verified visit which contains all of the following:
(a) The type of service performed.
(b) The individual receiving the service.
(c) The date of the service
(d) The location of service delivery.
(e) The individual providing the service.
(f) The time the service begins and ends.
SECTION 4 DHS 105.16 (1m) is created to read:
DHS 105.16 (1m) Electronic visit verification. The home health provider is required to capture and retain EVV records.
SECTION 5 DHS 105.17 (1g) (cm) is created to read:
DHS 105.17 (1g) (cm) Electronic visit verification. The provider is required to capture and retain EVV records.
SECTION 6 DHS 105.19 (7m) is created to read:
DHS 105.19 (7m) Electronic visit verification. The nurse is required to capture and retain EVV records.
SECTION 7. DHS 106.03 (2m) is created to read:
DHS 106.03 (2m) EVV Requirements for claim reimbursement. Claims for services that require EVV shall have associated EVV records for applicable services. Claims that require EVV that are not matched to an EVV record may be denied.
SECTION 8. DHS 107.02 (1) (am) is created to read:
DHS 107.02 (1m) When EVV is required for applicable services, claims shall be submitted in accordance with s. DHS 106.03 (2m). Claims that require EVV that are not matched to an EVV record may be denied. SECTION 9. Effective date. This rule takes effect on the first day of the month following publication in the Wisconsin Administrative Register, as provided in s. 227.22 (2) (intro.), Stats.
