Rider 56: Appropriate Care Settings for Individuals with Severe and Persistent Mental Illness and Co-Occurring Conditions Study
October 27th, 2025 HHSC Rider 56 (89th Texas Legislature): According to HHSC, it’s in the beginning stages of implementation but plans to engage stakeholders in the process in early January as well as publish a communication about the Rider and related implementation plans. Rider 56: Appropriate Care Settings for Individuals with Severe and Persistent Mental Illness and Co-Occurring Conditions Study. Out of funds appropriated in Strategy D.2.5, Community...Cameras In Private Areas (HCS Program): Update
October 23rd, 2025 HCS Program & Cameras in Private Areas: HHSC Medicaid division sent Regulatory staff at HHSC an email informing them that “CMS thinks there’s a privacy concern regarding cameras being allowed in private areas (even if justifications are in place), and that CMS will no longer permit this practice.” According to HHSC, currently, there are no HCS rules specific to this matter. HHSC stated that more details will be...Change in IDD Waiver Cost Limits
October 23rd, 2025 New cost limits for the IDD waivers are as follows: For DBMD and CLASS, HHSC updated the individual cost limits from $114,736.07 to $149,774. For TxHmL, HHSC updated the individual cost limit from: $17,000 to $31,684. For HCS, HHSC updated the individual cost limit based on level of need (LON) as described below: Intermittent (LON 1), Limited (LON 5), and Extensive (LON 8) The amount is increasing from $167,468 to $169,182. Pervasive (LON 6) The...PEMS Streamlining Process For TMHP Enrollment
October 22nd, 2025 PEMS Update: HHSC and TMHP have been working on changes to the Provider Enrollment and Management System (PEMS) process in conjunction with a workgroup comprised of external stakeholders which cross all Medicaid programs subject to this federal requirement. Though not all changes can be made at once, HHSC will soon begin making incremental changes. HHSC/TMHP will test changes with volunteer representatives before initiating permanent changes....ANE Investigations Backlog Issue: HHSC Rider 164
October 22nd, 2025 There has been and still currently is a big backlog of ANE Investigations: Currently, over 3,000 ANE intakes in the HCS program are pending investigations. The 89th Texas Legislature appropriated one-time funds for HHSC to hire 31 staff to investigate and close these cases. See excerpt from HHSC Rider 164 below. Is there a point of contact that providers can reach out to check on the status of an open case and how they can obtain a final...Upcoming Events
Apr
29
Wed
9:30 am
2-Day Workshop (CANCELLED)- “Bes...
@ Private Provider's Association of Texas
2-Day Workshop (CANCELLED)- “Bes...
@ Private Provider's Association of Texas
Apr 29 @ 9:30 am – Apr 30 @ 4:30 pm
2-Day Workshop (CANCELLED) We do apologize. Look for a future session, possibly in Houston or Dallas. If you would like to watch our shorter pre-recorded session, please contact us at meghanjones.tx@gmail.com “Best Practices For HCS[...]