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HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 14

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Since May 2, 2022, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers, local intellectual and developmental disability authorities (LIDDAs), and financial management services agencies (FMSAs) billing on behalf of consumer-directed services (CDS) have been submitting claims and forms to the Texas Medicaid & Healthcare Partnership (TMHP). TMHP has received feedback from providers and LIDDAs indicating additional support is required. Resolutions regarding the most frequently reported issues are found in the table below.

Topic

Resolution

Enhancements to Updating the Effective Date for Certain Forms

As part of the recent TMHP Long-Term Care Online Portal (LTCOP) enhancements, LTCOP users submitting an Individual Plan of Care (IPC) Revision, IPC Correction, or Individual Movement (IMT) Correction form will see the following message for the effective date: “If Effective date is updated, please click the search icon to refresh the client information based on the Effective date.”

The user must click the search button (the magnifying glass icon) after changing the effective date to refresh the client data to reflect the new effective date.

If the user does not click the search button after changing the effective date, the following error message will be displayed: Search button for the effective date needs to be clicked to get latest client information.

More information on how to enter the effective date for these forms can be found in the 3608 HCS Individual Plan of Care Item-by-Item Guide, 8582 TxHmL Individual Plan of Care Item-by-Item Guide, and Individual Movement Form Item-by-Item Guide.

Provider Enrollment and Management System (PEMS) Revalidation

All HCS and TxHmL program providers currently enrolled in PEMS will be required to revalidate their enrollment every three years.

Providers can find the effective dates of their enrollment period within PEMS and on their provider welcome letter.

Providers should submit their revalidation applications at least 90 days before the end of their enrollment period so that it can be processed before the enrollment period ends.

If the provider’s enrollment period ends before the provider completes the revalidation process, there will be a gap in the provider’s Medicaid enrollment. The provider will not be reimbursed for services rendered from the day after the enrollment period ends until the day on which the provider successfully completes the revalidation process.

More information can be found on the TMHP Provider Enrollment page.

View previous postings below:

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 13

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 12

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 11

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 10

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 9

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 8

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 7

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 6

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 5

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 4

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 3

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 2

HCS and TxHmL Waiver Programs: Trending Issue Support

HCS and TxHmL Providers Must Use Bill Codes Listed in the HCS and TxHmL Bill Code Crosswalk for Claims Submission

Important Claims Submission Information for HCS and TxHmL Programs

LTC Online Portal Dashboard Accessibility Issue Resolved

IPC Forms 3608 and 8582 Issue Resolved

HCS and TxHmL FAQ Updates Available May 9, 2022, and May 23, 2022

Individual Plan of Care (IPC) Training Materials for HCS and TxHmL Waiver Programs

Now Available: HCS and TxHmL Programs Forms and Claims Submissions to TMHP

EVV Updates for the HCS and TxHmL Transition to TMHP for Claims Submission

For help with any additional questions, contact the TMHP LTC Help Desk at 800-626-4117 (select option 1 and then option 7).