Texas Home Care Compliance Calendar — 2026 Deadlines

Running a Texas home care agency means managing compliance on three different calendars at once: the HCSSA licensing cycle, the Medicaid billing cycle, and the MCO credentialing cycle. These rarely align, deadlines arrive without warning, and missing one can suspend your ability to bill.

This calendar covers every recurring compliance deadline for Texas Personal Assistance Services (PAS) and Comprehensive HCSSA agencies — organized by frequency so your team can build a working compliance system around it.

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EVV compliance isn't an annual event — it's a daily operations task with weekly review deadlines.

What to do every week:

• Review open EVV exceptions in your EVV system (Sandata or HHAeXchange) — typically by end of business Friday
• Resolve or document every exception before it ages into the next billing cycle. Unresolved exceptions become claim denials
• Verify that all completed visits have six-element EVV data: who, who, what, when, when, where
• Audit manual override documentation — every manual entry needs a reason code and supporting notes. More than 10% manual overrides is an audit risk signal

Texas-specific deadline: TMHP claim submission window is 95 days from the date of service for most Medicaid programs. EVV exceptions must be resolved before claims can be submitted. A backlog of unresolved exceptions blocks the entire billing cycle.

See the full EVV compliance guide: EVV Compliance for Home Care Agencies →

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First week of every month:

• Submit claims for all services completed in the prior month — or confirm your biller has submitted
• Reconcile EOBs (Explanation of Benefits) from TMHP and each STAR+PLUS MCO payer (Superior, Molina, UHC, Aetna, Community First)
• Post denials to a denial log and initiate appeals within the payer's timely filing window (typically 90–120 days from the original claim date)
• Run a report on authorizations expiring in the next 30 days — request renewals before they lapse

Authorization management (monthly rolling task):

Authorization lapses are among the most common reasons Texas home care agencies lose revenue. Every month:

• Pull a list of all active authorizations expiring in the next 45 days
• Submit renewal requests to each MCO or TMHP at least 30 days before expiration
• Document submission dates and confirmation numbers — you will need these if the renewal falls through

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Every 90–120 days:

CAQH ProView is the central credentialing database used by all four major STAR+PLUS MCOs in Texas (Superior Health Plan, Molina Healthcare, UnitedHealthcare Community Plan, and Aetna Better Health). Your agency's CAQH profile must be re-attested every 90–120 days or it becomes inactive.

When your CAQH attestation lapses:

• MCO credentialing departments flag your file as "incomplete"
• New credentialing applications are put on hold
• Existing MCO contracts may be suspended pending re-attestation

Quarterly CAQH checklist:

• Log into CAQH ProView at proview.caqh.org
• Review all provider information for accuracy (key personnel, NPI, addresses, licensure)
• Re-attest before the expiration date shown on your profile
• Download the updated attestation confirmation for your credentialing file
• Notify any MCOs with pending credentialing applications of your renewed attestation

Set a recurring calendar reminder: every 90 days from your last attestation date. Do not wait for CAQH to notify you — notifications go to the email on file and can be missed.

For a full walkthrough of STAR+PLUS MCO credentialing requirements: Texas STAR+PLUS MCO Provider Enrollment Guide →

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January–February: New Year Operational Review

Review and update your Policies & Procedures Manual.

HHSC requires that your P&P manual be reviewed and updated at least annually. January is the recommended time to conduct this review — before the HCSSA survey season begins in spring for agencies with Q1 license anniversaries.

• Review 26 TAC Chapter 97 for any regulatory updates that took effect January 1
• Update all dated references in the P&P manual (forms, contact information, fee schedules)
• Document the review date and the name of the administrator who completed it
• If any sections were revised, note the change and the reason

Update your HHSC Provider Address and Contact Information.

TMHP and HHSC send renewal and compliance notices to the address and email on your enrollment record. If this information is stale, you will miss notices.

• Log into the TMHP Provider Portal (TMHP.com) and verify your address, email, and phone
• Verify your HHSC Provider Contact Information is current in the HHSC provider portal
• Update NPI registry information (NPPES) if address or administrator has changed

March–May: HCSSA Survey Preparation Season

For agencies licensed in Q2–Q3 (April–September), the HHSC annual survey typically falls in this window. Prepare 60 days in advance.

60 days before your expected survey window:

• Pull your most recent HHSC survey report and review any deficiencies cited
• Confirm all prior deficiencies have corrective action plans on file with documented resolution
• Run a personnel file audit: verify all staff records include current background checks, training logs, TB tests, and competency evaluations
• Verify client records are current: assessments, care plans, service authorizations, and EVV-matched visit notes
• Confirm your administrator's licensure and continuing education credits are current

30 days before:

• Conduct a tabletop walkthrough of your P&P manual — can your staff explain each policy?
• Verify your HCSSA license is posted in your agency office (required by 26 TAC §97.244)
• Confirm your HHSC survey contact information is current so the surveyor can reach you
• Prepare your EVV compliance documentation: exception log, resolution log, manual override documentation

For the full HCSSA survey preparation checklist: Texas HCSSA License Application Checklist →

March: OIG Exclusion Checks

Federal law prohibits Medicaid-enrolled providers from employing individuals who appear on the HHS Office of Inspector General (OIG) Exclusion List. Texas requires this check:

• At hire — before any employee provides Medicaid-billable services
• Monthly — for all active employees and contractors

Annual March task: Establish or audit your monthly OIG exclusion check process. Document that each employee was checked, the date, and the result. The OIG LEIE database is searchable at oig.hhs.gov/exclusions/exclusions_list.asp.

April: HCSSA License Renewal

HHSC HCSSA licenses are issued on a 1-year renewable basis. Your renewal notice arrives approximately 60–90 days before your expiration date.

Upon receiving your renewal notice:

• Verify all information on the renewal application is current
• Confirm your administrator and alternate administrator information is correct
• Confirm no disciplinary actions or enforcement proceedings are pending
• Submit the renewal and associated fee before the expiration date

Never let your HCSSA license expire. A lapsed license requires a new application — typically a 3–6 month process — during which you cannot legally serve clients or bill Medicaid.

June: MCO Annual Credentialing Renewal

Most STAR+PLUS MCOs conduct annual credentialing renewal cycles for provider agencies. The exact timing varies by MCO and your enrollment date, but June through August is the most common renewal window.

MCO credentialing renewal checklist:

• Review notification from each MCO (Superior, Molina, UHC, Aetna, Community First) for renewal deadlines
• Prepare updated credentialing documentation: agency NPI, HCSSA license copy, key personnel information, CAQH attestation confirmation
• Submit renewal applications at least 45 days before the MCO deadline — earlier is always better
• Follow up with each MCO credentialing department within 2 weeks of submission to confirm receipt

Missing an MCO annual renewal can result in temporary contract suspension — meaning you can continue to serve existing clients but cannot accept new referrals through that MCO.

For MCO credentialing support: Home Care Credentialing Support →

For understanding which MCOs are in your service area: Texas STAR+PLUS Payer Guide →

August–September: Staff Training and Competency Review

HHSC requires that all home care aides complete competency evaluations and continuing education annually. This is one of the most commonly cited deficiencies in HCSSA surveys.

Annual staff compliance audit:

• Pull training logs for all caregivers active in the past 12 months
• Verify each caregiver has completed their annual competency evaluation (skills checkoff)
• Confirm completion of any state-required continuing education topics (infection control, abuse and neglect reporting, emergency preparedness)
• Update personnel files with current training certificates
• Verify annual TB screening or attestation of non-exposure is documented for all staff

Administrator continuing education: The HCSSA-designated administrator must complete continuing education in healthcare management topics. Document the hours completed and the topics covered.

October: TMHP Medicaid Revalidation Due-Date Check

Texas Medicaid (TMHP) requires all enrolled providers to revalidate their enrollment every three to five years depending on provider type — most providers are on a five-year cycle. Your due date is your enrollment period end date in PEMS, and revalidation notices are sent to the contact information on your TMHP provider record ahead of it. Because a missed notice is the most common way agencies get suspended, check your due date on a fixed annual schedule — October works well — and confirm your contact information is current.

Annual check (and full revalidation process when your window opens):

• Log into the TMHP Provider Portal (PEMS) and confirm your enrollment period end date and contact information
• If a revalidation notice is pending, navigate to it and complete the steps below
• Update your provider profile: address, phone, email, key personnel, authorized representatives
• Confirm your HCSSA license number and expiration date are current
• Submit a new OIG exclusion check for all key personnel listed on your enrollment
• Pay any applicable revalidation fee

Critical: Failure to revalidate by the deadline results in automatic suspension of your Medicaid enrollment. Once suspended, you cannot submit new claims until revalidation is complete — which can take 30–60 days after submission.

October 1: New ICD-10 Codes Take Effect

Federal fiscal year begins October 1. CMS releases updates to ICD-10-CM diagnosis codes annually, effective October 1. If your billing uses diagnosis codes tied to client conditions, audit your code list and update any codes that were revised or deleted in the new code set.

November–December: Year-End Compliance Review

Before December 31:

• Run a year-end audit of all open MCO credentialing applications — anything still "pending" needs follow-up
• Review your denial and appeals log — any appeals still pending need resolution before year-end
• Conduct a personnel records audit for any staff hired in the second half of the year
• Confirm all CAQH attestations are current through Q1 of the following year
• Update your billing fee schedule if TMHP has issued a new rate schedule for the coming year

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Some compliance deadlines are not calendar-driven — they are triggered by specific events. These are the ones most likely to catch agencies off guard.

When You Hire a New Employee

• OIG exclusion check before first day of Medicaid-billable work
• Texas Health and Human Services Employee Misconduct Registry (EMR) check
• Background check through an HHSC-approved vendor
• TB screening or attestation
• Competency evaluation before unsupervised client contact
• Add employee to your EVV system and confirm timekeeping enrollment

When a Key Staff Member Leaves or Changes

• Update your HCSSA administrator of record with HHSC if the designated administrator changes — HHSC must approve the new administrator before the transition
• Update CAQH ProView with the new administrator's information
• Notify each active MCO of the administrator change — most MCOs require formal notification within 30 days
• Update your TMHP enrollment record

When Your HCSSA License Address Changes

• Notify HHSC in writing (required for any change in your agency's primary location)
• Update TMHP provider record
• Update each MCO contract with your new address
• Update CAQH ProView

When an MCO Sends a Credentialing Information Request

• Respond within the MCO's deadline (typically 30 days) or your file is closed
• Gather all requested documentation before responding — partial submissions restart the clock
• Send via the channel specified in the request (CAQH, direct portal, or secure email)
• Document submission date and confirmation for your records

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No two Texas home care agencies have the same calendar — your compliance deadlines depend on your license anniversary date, your MCO enrollment dates, and your staffing cycle. Here is how to build your agency-specific calendar:

1. Identify your anchor dates: HCSSA license anniversary, TMHP enrollment date, and the date of your last CAQH attestation. These are the three dates everything else is scheduled from.
2. Map the annual cycle: Place your HCSSA survey prep (60 days before anniversary), HCSSA renewal (90 days before expiration), TMHP revalidation due-date check (October) with full revalidation at your PEMS enrollment period end date, and MCO annual renewals (June–August target).
3. Set quarterly CAQH reminders: Starting from your last attestation date, set a calendar alert every 90 days.
4. Build weekly EVV review into your operations: This cannot be a monthly task — EVV exception backlogs accumulate fast and become expensive to resolve.
5. Delegate recurring tasks: Most of the tasks on this calendar are operational, not clinical. They can be managed by a trained back-office specialist who knows your payer portals and EVV system.

Most Texas home care agencies managing 5+ clients are carrying 40–80 recurring compliance tasks per year. Agencies that let these slip into a reactive mode — responding to notices rather than managing ahead of deadlines — consistently see higher claim denial rates, MCO contract tensions, and survey deficiencies.

Managing compliance proactively is a back-office operations function. See how Atlas Care virtual assistants manage compliance tasks for Texas agencies →