Regulatory Updates

Texas House Bill 4224 Updates Medical Records Privacy Provisions

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

In May 2025, Texas passed House Bill 4224 which provided updates to Texas Health and Safety Code Chapter 181. These updates were effective September 1, 2025. Agencies/Organizations should review policy and practices to ensure compliance.

Termination of Designation of Somalia for Temporary Protective Status

Program: Home Care, Home Health, Hospice

A notice was posted to the Federal Register on January 15, 2026, by DHS US Citizenship and Immigration Services regarding the Temporary Protected Status for Somalia. The designation of Somalia for Temporary Protected Status will be terminated March 17, 2026, 11:59pm local time.

Minnesota Implement License Moratorium

Program: Home Care

Minnesota DHS implemented a temporary 245D licensing moratorium for Home and Community-Based Services (HCBS). This moratorium will go into effect on January 1, 2026, with an anticipated duration of 24 months, ending December 31, 2027.

Termination of the Designation of Haiti for Temporary Protected Status

Program: Home Care, Home Health, Hospice

A notice was posted to the Federal Register on 11/28/2025 by DHS US Citizenship and Immigration Services regarding the Temporary Protected Status for Haiti. The designation of Haiti for Temporary Protected Status will be terminated February 3, 2026, 11:59pm local time.

Texas HHSC Updates General FAQs for HCSSAs

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

Texas Health and Human Services Commission has provided an update to their General FAQs for Home and Community Support Services Agencies.  The most current version is dated August 2025.

CMS Issues Waivers for Texas Flood Impacted Areas

Program: Acute Care Hospital, Durable Medical Equipment and Supplies, Home Care, Home Health, Hospice, Renal Dialysis

CMS declared a public health emergency for the State of Texas on July 8, 2025, allowing the Secretary to issue 1135 waivers to provide flexibility and support for Texas providers. These waivers are effective retrospectively to July 2, 2025. CMS has updated their website to include information related to the waivers as well as additional resources for the impacted areas.

CDPH All Facilities Letter 25-19 Updates Application Process

Program: Home Care, Home Health, Hospice

On June 26, 2025, California Department of Health issued AFL 25-19 to all facility types.  This provider letter outlines changes in the application process effective July 1, 2025. These changes include application fees and denials of incomplete licensing application packets.

Florida HH Licensing Regulations Updated – Effective July 1, 2025

Program: Home Care, Home Health, Home Infusion Therapy, IRN

Florida House Bill 1353 was passed this month updating the home health licensure regulations.  These regulations affect providers who are subject to a home health license such as home health providers, home care providers, home infusion therapy providers, and infusion nursing service providers.  Updates included are administrator requirements in 400.476, nursing workforce requirements in 400.487, and the Excellence in home health program in 400.52. These changes are effective July 1, 2025.

Texas HHSC Reminds Regulated Providers to Update Emergency Preparedness Plans for Hurricane Season

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

AUSTIN – The Texas Health and Human Services Commission is urging health care facilities, child care operators and other providers to update their safety procedures and emergency response plans as the 2025 Atlantic hurricane season begins on June 1.

The National Oceanic and Atmospheric Administration forecasts a range of six to 10 hurricanes in the Atlantic Ocean this season. Of those, three to five are expected to be major hurricanes of Category 3 or higher. An average Atlantic hurricane season has three major hurricanes.

“We’ve seen the dangerous and sometimes deadly consequences of severe weather in Texas,” said Stephen Pahl, deputy executive commissioner of HHSC Regulatory Services Division. “That’s why it’s so important to have a current emergency preparedness plan that staff can implement quickly and effectively to protect vulnerable clients.”

HHSC requires long-term care providers such as nursing facilities, assisted living facilities, hospices and state-regulated group homes to regularly prepare for natural disasters, including hurricanes and flooding. HHSC also requires child care operations and acute health care facilities such as hospitals and dialysis centers to maintain an updated plan and ensure staff are fully trained to implement it during a crisis.

A provider’s emergency plans for extreme weather should address:

• Power loss.
• Water and food needs.
• Communication to families and staff.
• Staff shortages and responsibilities.
• Continuation of care and treatment for individuals.
• Sheltering in place, evacuation and transportation, as applicable.
• Facilities with generators should perform any maintenance or needed testing to ensure the equipment functions during a power loss.

HHSC issues guidance to providers about updating their plans and encourages them to visit the Department of State Health Services Texas Ready website for hurricane preparedness resources, including sample plans, supply checklists and other information on emergency preparedness.

The Atlantic hurricane season, which affects the Texas Gulf Coast, continues through Nov. 30.

About HHSC Disaster Services

In the event of an emergency, HHSC Disaster Services provides public health and medical support, shelters for people with medical needs, counseling services, disaster food assistance and water and ice. The program also provides regulatory support for health care facilities, long-term care facilities and child care operations, and special waivers for Medicaid providers and clients as needed.

Florida Medicaid: Private Duty Nursing and Family Home Health Aide Services Coverage Policy

Program: Home Care, Private Duty

AHCA has released the finalized Medicaid Private Duty Nursing and Family Home Health Aide Services Coverage policy update.  Updates to the policy include terminology changes, eligibility & coverage requirements, documentation requirements, and reimbursement updates.

Florida – All Provider Types UPDATE: Hurricane Debby – Key Medicaid Information for Fee-for-Service and Managed Care Providers

Program: Acute Care Hospital, Ambulatory Surgical Centers (ASC), Clinical Laboratory, Critical Care Hospital, Durable Medical Equipment and Supplies, Home Care, Home Health, Home Infusion Therapy, Hospice, Pharmacy, Renal Dialysis, Sleep

The purpose of this alert is to provide an update to the previous provider alert issued on 08/04/2024 regarding Hurricane Debby.

The following flexibilities/waivers offered to providers in the alert issued on 08/04/2024 will expire at 11:59 p.m. on Tuesday, September 3, 2024:

• Waiver of prior authorization requirements for critical Medicaid services
  • The lifting of early prescription refill edits will remain in place in accordance with Governor Ron DeSantis’ emergency executive orders issued for Hurricane Debby
• Waiver of service limitations to ensure a recipient requiring critical Medicaid services during the storm receives such care
• Temporary postponement of the Preadmission Screening and Resident Review processes

Additional questions from providers may be directed to the Florida Medicaid Contact Center at 1- 877-254-1055

Texas Home and Community Support Services Agencies – FAQs Updated

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

Texas Health and Human Services updated the FAQ document for Texas Home and Community Support Services Agencies (HCSSAs).  The most current version is dated April 2025.  Updates include emergency communication system sign up requirements (AlertMedia) and use of the Critical Incident Management System (CIMS) for reporting abuse, neglect, and exploitation.

Texas HHSC PL 2025-01: New Emergency Communication Tool – AlertMedia

Program: Assisted Living, Home Care, Home Health, Home Infusion Therapy, Hospice

On January 7, 2025, Texas Health and Human Services Commission issued Provider Letter 2025-01 New Emergency Communication Tool – AlertMedia.  The provider letter is applicable to all providers in the Long-Term Care division including hospices, home and community support services, and assisted living facilities.  Providers should review this provider letter for policy details and provider responsibilities.  Provider responsibilities must be met no later than February 15, 2025.

Texas HHSC Rescinds PL 2024-20 Requirements for Tuberculosis Screening and Testing

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

On November 1, 2024, Texas HHSC rescinded Provider Letter 2024-20 Requirement for Tuberculosis Screening and Testing.  During the interim, providers are to follow agency procedures regarding communicable diseases, infection control, and TB testing/screening.  Texas HHSC recommends agencies utilize resources from the CDC and Texas Department of State Health Services to inform the agency’s policies and procedures (links provided).

Florida: Home Health Aide for Medically Fragile Children Annual Assessment Due Nov 1

Program: Home Care, Home Health

Florida statutes require that AHCA conducts an annual assessment of the home health aide for medically fragile children program.  Applicable agencies, providing skilled services to children under the age of 21, are required to complete an agency utilization assessment and report data to AHCA.  The assessment can be completed online.  This assessment must be submitted to AHCA no later than November 1, 2024.

New Jersey Domestic Workers’ Bill of Rights Act Effective July 1, 2024

Program: Home Care

The New Jersey legislature approved the Domestic Workers’ Bill of Rights Act January 12, 2024.  This act will be effective July 1, 2024.  Healthcare Service Firms are encouraged to familiarize themselves with the Act.  The Act addresses employment rights and protections including, but not limited to, minimum wages and overtime pay; written contracts between domestic workers and employers; meal/break times; hours worked; termination of the contract.

California ALF – Hot Summer Weather Advisory

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

​All Facilities Letter Summary

• This AFL reminds health care facilities to implement recommended precautionary measures to keep individuals safe and comfortable during extremely hot weather.
• Facilities must have contingency plans in place to deal with the loss of air conditioning, or in the case when no air conditioning is available, take measures to ensure patients and residents are free of adverse conditions that may cause heat-related health complications.
• Facilities must report extreme heat conditions that compromise patient health and safety and/or require an evacuation, transfer, or discharge of patients.

New Texas Requirement for HCSSAs

Program: Home Care, Home Health

Texas Health and Human Services Commission issued Provider Letter 2024-10 April 18, 2024.  This letter outlines the requirements for HCSSAs with a home health category (if the agency employees 2 or more registered nurses) to adopt and implement a workplace violence prevention program no later than September 1, 2024.

Texas Provider Letter 2024-06 Teleservices in HCSSAs

Program: Home Care, Home Health, Hospice

Texas Health and Human Services Commission issued Provider Letter 2024-06 April 3, 2024.  This provider letter is applicable to Home and Community Support Services Agencies and provides guidance for those agencies who provide teleservices.

Ohio Medicaid HCBS Direct Care Worker Relationship Rule

Program: Home Care

Ohio recently implemented OAC 5160-44-32 Home and Community Based Medicaid Waiver Program Provider and Direct Care Worker Relationships.  Ohio Department of Medicaid has training and resources available to assist applicable agencies implement this rule.  This rule became effective January 1, 2024.

Florida Providers – Licensure Renewal Application Process Revised

Program: Acute Care Hospital, Ambulatory Surgical Centers (ASC), Assisted Living, Behavioral Health, Clinical Laboratory, Home Care, Home Health, Home Infusion Therapy, Hospice

Pursuant to Florida Rule 59A-35.060, effective March 5, 2024, all providers will be required to submit renewal applications through AHCA’s online licensing system.

Texas Home and Community Support Services Agencies – Updated FAQs

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

Texas Health and Human Services Commission has updated the FAQs for Home and Community Support Services Agencies.  The most recent version is February 2024.

Texas Home and Community-based Services Billing Requirements Updated

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

Texas Health and Human Services recently issued a revision to the program billing requirements for home and community-based services providers.  The update is revision 24-1 and was effective January 1, 2024.  Make sure you have the latest version.

Texas Provider Letter PL 2024-05 – Administrator and Alternate Administrator Requirements for HCSSAs

Program: Home Care, Home Health, Home Infusion Therapy, Hospice

Texas Health and Human Services issued provider letter PL 2024-05 February 8, 2024.  This is applicable to home and community-based service agencies. The update outlines information required for the administrator and alternate administrator.  This provider letter replaces PL 2021-37.

Florida Alzheimer’s Disease & Related Disorders (ADRD) Training

Program: Assisted Living, Home Care, Home Health, Home Infusion Therapy

Florida recently updated Florida Statute 430.5025 Alzheimer’s disease and related forms of dementia; education and training.

North Carolina Home Care Agency and Home Assistance Services Provider Licensure Act 2023

Program: Assisted Living, Home Care

Home Care Agency and Home Assistance Services Provider

Provides that home assistance services providers shall, among other things, maintain liability insurance, inform all new clients that they do not provide health care or hands-on care, and conduct a criminal background check in each State where any contractor or employee was a resident during the past specified number of years; directs the Department of Health and Human Services to exempt certain home assistance services from home care licensure requirements.