PEMS: Update On HCS Revalidations For Current Providers

by | Jun 28, 2024

June 28th, 2024

Town Hall about HCS enrollment requirements in PEMS

Home and Community-based Services (HCS) providers must list their practice locations and billing offices in the Provider Enrollment and Management System (PEMS). Please review the following article which HHSC published on 5/2/2024 for more information:

https://www.hhs.texas.gov/sites/default/files/documents/hcs-revalidation-notice.pdf

To help you add or maintain your practice locations in PEMS, the Texas Medicaid & Healthcare Partnership (TMHP) is hosting a town hall webinar to discuss how to access PEMS, the requirements for revalidation requests, and adding, completing, or disenrolling practice locations from your enrollment record.

Sign Up for the Town Hall

To register, select one of the following sessions to attend, and fill out the required fields:

The sessions will also be recorded and available on the TMHP website.

Use These Resources

You can also view the following resources to learn more information about PEMS:

If you have any questions about the webinar, please contact provider.relations@tmhp.com.

June 20th, 2024

Information Letter 2024-06

HHSC has published the following information letter IL 2024-06, Practice Locations in the Home and Community-based Services Program

 Information Letter 2024-06, Practice Locations in the Home and Community-based Services Program.

The letter informs providers of requirements related to HCS practice locations.

Questions about the state and federal requirements for practice locations may be sent to providerenrollmentmanagementsystem@hhs.texas.gov.

Questions about this Information Letter may be sent to HCSPolicy@hhs.texas.gov.

June 10th, 2024

Update:  Issues Concerning Challenges With The Revalidation Process at PEMS

 Access the May 2, 2024 PEMS Guidance at:  https://www.hhs.texas.gov/sites/default/files/documents/hcs-revalidation-notice.pdf
**If you experience challenges with your revalidation or have questions, please send them to the following email box: Oversight@hhsc.state.tx.us
3.  According to the above-referenced May 2, 2024 PEMS Guidance, if one’s revalidation falls within Group 1, meaning the revalidation was due BEFORE January 1, 2024 but was never submitted, providers had until June 1, 2024 to submit a completed revalidation application.  Providers in Group 1,now have until June 17, 2024 to complete their applications.  A provider in this group who fails to submit a re-enrollment application by this new date may be subject to additional sanctions including, recoupment, vendor hold, and contract termination.  HHSC is contacting all HCS providers included in Group 1 who failed to meet the June 1, 2024 deadline to not only inform them of the new due date, but also to remind them that TMHP has yet to receive their application.
**Kaliope Schmidt, HHSC, is calling these providers and sending a follow-up email if a provider has not yet returned her call.  Please start the process now, if you have not done so already and fall into group 1 category.
Remember-ALL Host Home (HH) locations are considered practice locations and MUST be entered on the application. Note: There may have been a miscommunication earlier that 3rd party HH locations did not have to be entered, but ALL must be entered.
Job Aid Manual that explains how to add Practice Locations.   According to HHSC and TMHP, the number of locations in PEMS need to match the number of locations in LTC-OP.  The FAQ at the following link provides information on how to add or close locations in the LTC-OP (see page 47, FAQs 4.60 and 4.61):  HCS and TxHmL Waiver Programs Frequently Asked Questions (tmhp.com)
When possible, we have been informed, that TMHP will leverage previous HCBS Settings reviews, meaning that any practice locations which underwent an HCBS Settings review within the last 2 years, will not be subject to an on-site revalidation visit.   See bottom of page 1 in the above-referenced May 2, 2024 PEMS Guidance for further details.  
** Important Note:
 HHSC and TMHP will conduct a webinar later this month to review the May guidance regarding practice locations and address other issues HCS providers are experiencing with the revalidation process.  The 1.5 hour webinar will include 45 minutes for Q&A.  Once a date and time are posted, we will gladly share registration information.

March 11th, 2024

The notice below provides an email address/box for providers to use in obtaining assistance with the revalidation process, please remember to contact HHSC’s oversight email box to report any inconsistencies you receive from TMHP representatives regarding practice locations, site visits and payment holds.   That email address is:  oversight@hhsc.state.tx.us

(HCS) Providers May Continue Submitting Service Claims While Completing Medicaid Enrollment Revalidation

“The Texas Health and Human Services Commission (HHSC) is aware that 1915(c) HCS providers are experiencing delays in completing Medicaid enrollment revalidation through the Texas Medicaid & Healthcare Partnership (TMHP), due to the need for additional clarification and guidance for submitting practice location information. HHSC and TMHP are working to address this and will provide further clarifications and instructions to HCS providers in the near future.

In the meantime, HCS providers that intend to stay enrolled in Medicaid must continue to work with TMHP to complete all aspects of Medicaid enrollment revalidation not related to practice locations. HCS providers that intend to stay enrolled in Medicaid may continue to submit electronic service claims for services rendered even if their Medicaid enrollment revalidation date has passed because of process delays related to practice location issues. Further, HCS providers will not be placed on vendor hold if their Medicaid enrollment revalidation has been submitted in the Provider Enrollment Management System but has not been completed because of issues related to practice locations and site visits.

HCS providers that need assistance with completing the steps for revalidation can contact the TMHP Provider Relations department at provider.relations@tmhp.com.”

**A TMHP representative can schedule an enrollment walkthrough to assist with questions and completing the revalidation steps.