Pre-enrollment Site Visit Required for HCS and TxHmL Providers That Enrolled Through PEMS

Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver program providers that enrolled through the Texas Medicaid & Healthcare Partnership (TMHP) Provider Enrollment and Management System (PEMS) will be subject to a pre-enrollment site visit from TMHP.

The pre-enrollment site visit is required for enrollment in Texas Medicaid. The HCS program site visits will be conducted at the locations listed on the enrollment application, including the business office and any locations where clients receive residential assistance services.

A TMHP site visit coordinator will reach out through email or phone to schedule a visit. If the TMHP site visit coordinator is unable to reach the provider, then TMHP will conduct an unannounced site visit.

If providers have questions, contact the TMHP LTC Help Desk at 800-626-4117 (select option 1 and then option 7)

A few items I want to make you aware of if you are a new HCS/TxHmL Provider Applicant:

1. They may want to know what services you intend to use to bill via TMHP.
   1.   i.e. TMHP billing specialist, or billing agency, someone at your agency using only TMHP or also specific outside software to make it easier to monitor and complete your billing (i.e. Millen Pro Billing services and/or software), or via Electronic Health Records for instance that have TMHP and EVV billing capabilities (TaskMaster Pro, TMHP, etc..)
2. You do not have to have a group home when they visit before you have a contract.  You don’t have clients yet and HCS does not require you to purchase or rent a home prior to receiving your contract. (Adult Mental Health HCBS program does require you have a home)
3. You do not have to have a rented business office or “storefront”.  You can use your “home office”.  But you may need to explain how you intend to see your clients, meet potential families and clients or do staff trainings and still maintain privacy.  Perhaps you can ask your local LIDDA’s if they have meeting spaces available to the providers, or you may use virtual office space, hotel conference/meeting rooms, and any staff training for group homes that will happen in the group home for example..
4. Make sure if it is a home office, that it really is a delegated space for your office.
5. They may want to know how you plan to maintain privacy and security with client records electronically stored, transferred, shared, or disposed of.
6. They may request a few policies (security and privacy inquiry form policies and procedures, complaint process, etc..) please contact me if you want a list of the rest or if you want to hire us to provide some of them for you. Twogether Consulting Ph: 512-294-8032