A health care provider that provides to recipients personal care services, attendant care services, or other services the commission identifies shall:
(1) use the electronic visit verification system or a proprietary system the commission allows as provided by § 532.0258 to document the provision of those services;
(2) comply with all documentation requirements the commission establishes;
(3) comply with federal and state laws regarding confidentiality of recipients’ information;
(4) ensure that the commission or the Medicaid managed care organization with which a claim for reimbursement for a service is filed may review electronic visit verification system documentation related to the claim or obtain a copy of that documentation at no charge to the commission or the organization; and
(5) at any time, allow the commission or a Medicaid managed care organization with which a health care provider contracts to provide health care services to recipients enrolled in the organization’s managed care plan to have direct, on-site access to the electronic visit verification system in use by the health care provider.

Text of section effective on April 01, 2025