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Certain Providers Must Revalidate Under CMS Revalidation Initiative

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The Texas Health and Human Services Commission (HHSC) has implemented a Medicaid provider revalidation strategy in response to a federal revalidation initiative by the Centers for Medicare & Medicaid Services (CMS). As a result, HHSC may require certain providers to revalidate sooner than their current due date or take other actions to ensure that their enrollment records are accurate by June 5, 2028.

The Texas Medicaid & Healthcare Partnership (TMHP) will notify providers that are affected by this change on October 31, 2026. TMHP will send notifications through the Provider Enrollment and Management System (PEMS), a physical letter, and email.

Revalidation Due Dates May Change

CMS requires all states to complete revalidations for impacted providers by June 5, 2028. To meet this requirement, TMHP may change the revalidation due dates for certain providers. TMHP will email the affected providers to notify them of the change. Providers can verify any due date changes in the Revalidation Due Dates column on the Provider Information page in PEMS.

Note: Providers can start their revalidation process up to 180 days before the due date and should start as soon as their revalidation period begins to allow for any corrections or additional screening during processing.

TMHP will send reminders 180, 120, 90, and 45 days before the revalidation due date to inform providers that they should complete their revalidation application.

Verify Email Addresses in PEMS

To receive the notifications through email, providers should ensure that their primary and secondary email addresses in their PEMS profile are current.

Important: Providers that use the State of Texas Electronic Provider System (STEPS) must ensure that their primary email address in PEMS reflects their primary entity contact (PEC) in STEPS.

To update the primary or secondary email address, providers should:

  1. Navigate to their Enrollment Record in PEMS.
  2. Select Edit Enrollment Record in the header.
  3. Select Create Request for the Maintenance – Provider Information – Change Email request type.

For further support, providers can refer to the Verifying an Email in PEMS job aid.

In-Flight Revalidation Applications

TMHP will notify providers with an in-flight revalidation application through PEMS if they are affected by the revalidation initiative. These providers should continue working to finalize their in-flight revalidation application.

Revalidation Extensions Not Applicable

Providers that are affected by this revalidation initiative are not eligible for any revalidation due date extensions. HHSC will disenroll them from Texas Medicaid and all associated state health care programs if their revalidation is not completed by the due date as specified in PEMS.

Providers that have been disenrolled must submit a reenrollment application through PEMS.

Important: Submitting a revalidation application by the due date is not enough to avoid disenrollment. A revalidation is complete only when the revalidation application status in PEMS shows “Closed-Enrolled.”

PEMS Revalidation Resources

Providers may refer to the PEMS educational videos on TMHP’s Provider Enrollment & Management System YouTube playlist, which includes the following:

The following resources provide more information about Medicaid provider revalidation requirements and common deficiencies to avoid:

Providers can access the Provider Enrollment Help page or the PEMS Instructional Site on tmhp.com for additional revalidation support.

For more information, call the TMHP Contact Center at 800-925-9126.