New HHS Requirement: Personal Care Services Oversight

Date: 10/01/20

Effective September 1, 2020, Texas Health and Human Services (HHS) mandated Managed Care Organizations (MCOs) to require Personal Care Services (PCS) agencies to conduct unannounced visits to validate that services for Medicaid (STAR Health, STAR Kids and STAR+PLUS) members were rendered and billed correctly.

To comply with this new MCO contractual requirement, Superior HealthPlan has initiated audits of randomly selected PCS agencies to validate agency compliance with program integrity policies and procedures. Superior is also conducting a representative sampling of supervisory oversight during PCS visits in the member’s home.

Upon receipt of a Superior PCS oversight audit request, all requested documentation should be submitted within the timeframe specified to Superior at Statewide.AM@SuperiorHealthPlan.com.

If you have any question regarding these requirements, please contact your assigned Account Manager.