Texas runs a Hybrid EVV model: TMHP is the state aggregator backend, and most STAR+PLUS MCOs require HHAeXchange as their operational portal. As of early 2026, Texas moved to hard-edit enforcement — unmatched claims are automatically denied, not reviewed. Here's how the two-layer system works and where most Texas agencies lose revenue.
Texas EVV involves two distinct layers — a state aggregator and an MCO-level portal — and most agencies operating under STAR+PLUS must understand both. Getting data into HHAeXchange is the operational step. Getting it to TMHP is the compliance requirement that governs payment.
Texas moved to hard-edit EVV enforcement as of early 2026. Claims that do not match a verified EVV record at the TMHP aggregator level are automatically denied — they do not reach a reviewer. Previously, soft edits allowed some unmatched claims to pass for manual review. Under hard edits, pre-submission exception resolution is no longer optional. Agencies that were managing exceptions reactively will see a direct and immediate impact on their claim approval rate.
Texas's statewide Medicaid claims processor and state-level EVV aggregator. TMHP is where all EVV compliance data ultimately must be recorded. Under hard-edit enforcement, TMHP automatically denies claims that don't match a verified visit record — no manual review step. TMHP administers EVV requirements for HHSC and sets the enforcement rules that all Texas payers operate within.
The portal most STAR+PLUS and STAR Kids MCOs require agencies to use for EVV submission. HHAeXchange is the operational touchpoint for most Texas home care agencies — exception queues, visit records, and caregiver verification all happen here. HHAeXchange data flows to TMHP for state-level compliance tracking. Verify which system your specific MCO requires, as requirements can differ by plan.
Texas's Hybrid model means there are both MCO-level EVV requirements (typically HHAeXchange) and a state-level aggregation requirement (TMHP). Agencies working across multiple MCOs navigate both layers simultaneously. An exception that isn't resolved before an MCO's submission window closes creates a gap in TMHP that triggers the hard-edit auto-denial — even if care was delivered and documented.
Texas adds a managed care layer to the standard EVV path, and hard-edit enforcement makes each step binary — a clean record moves forward, an unmatched record is auto-denied.
Attendant or caregiver clocks in and out via HHAeXchange at the participant's home. GPS, time, and caregiver identity are captured.
Visit data validates against the participant's active MCO authorization, attendant credentials, and service code. Exceptions appear in HHAeXchange for resolution before the MCO's window closes.
Clean HHAeXchange records transmit to TMHP. Under hard-edit enforcement, TMHP auto-denies any claim without a matching verified visit record — no manual review.
Claims that clear TMHP validation are processed by the MCO. Reimbursement follows each plan's payment cycle, which varies by MCO.
Texas EVV requirements apply to personal attendant services and home health services under STAR+PLUS and other HCBS waiver programs. The Hybrid model means agencies must meet both MCO-specific requirements and TMHP state aggregation requirements simultaneously.
Personal attendant services (PAS) under STAR+PLUS are Texas's highest-volume home care service type. PAS participants direct their own care and choose their own attendants — creating specific EVV requirements around attendant identity verification. The attendant of record in the MCO's authorization must match the individual clocking in through HHAeXchange. Identity mismatches are the most common exception type for PAS providers.
Texas agencies typically work with multiple STAR+PLUS MCOs simultaneously — each with its own prior authorization process, reauthorization cycle, service code requirements, and claim submission timeline. EVV requirements are consistent across MCOs (all flow to TMHP), but the administrative complexity of tracking multiple authorization periods means agencies that manage authorization manually face a much higher exception rate than those with automated tracking. This is where the largest authorization drain occurs for Texas agencies at scale.
Hard-edit enforcement changed the math in 2026: Before hard edits, a Texas agency with a 10% exception rate had 90% of claims processing normally — the other 10% went to soft-edit review, some of which recovered. Under hard edits, that same 10% exception rate means 10% of claims are auto-denied before review. The dollars at stake from unresolved exceptions are now materially higher.
Texas agencies managing multiple STAR+PLUS MCOs face exception resolution on multiple timelines simultaneously. Under hard-edit enforcement, an exception that isn't resolved before an MCO's window closes becomes an auto-denied claim — not a delayed one. The revenue cost of each unresolved exception increased when Texas moved to hard edits.
Estimated monthly revenue loss from HHAeXchange exceptions and lapsed credentials at 30 active patients. Under hard-edit enforcement, this figure increases for agencies that were relying on soft-edit recovery.
Texas agencies managing four to six MCOs at 90 patients often see compliance drain above this baseline. Exception timelines vary by plan, and manual exception management doesn't scale linearly with visit volume.
For Texas STAR+PLUS agencies, authorization drain — unused hours across multiple MCO authorization periods — is typically the single largest drain vector. Most agencies lose across all three vectors simultaneously.
The CareDrain Diagnostic takes 8 questions and gives you a dollar-quantified estimate of what your Texas agency is losing across authorization drain, claims drain, and compliance drain. For agencies working multiple MCOs, the authorization drain figure is often the first real number operators have seen for what they're leaving on the table each month.
Run the CareDrain Diagnostic →TMHP (Texas Medicaid Healthcare Partnership) is Texas's statewide Medicaid claims processor and state-level EVV aggregator — the back-end system where all Medicaid EVV compliance data must ultimately be recorded. HHAeXchange is the portal most STAR+PLUS MCOs require agencies to use for EVV submission, and HHAeXchange data feeds into TMHP. For most Texas home care agencies working with STAR+PLUS plans, HHAeXchange is the operational touchpoint. TMHP is where the state-level compliance record lives and where hard-edit enforcement happens.
As of early 2026, Texas moved to hard-edit enforcement for EVV. Under hard edits, claims are automatically denied at the TMHP aggregator level if they don't match a verified visit record in the system. Previously, soft edits allowed some unmatched claims to pass for manual review. Under hard-edit enforcement, an unmatched claim doesn't reach a reviewer — it is auto-denied. Pre-submission exception resolution is now essential rather than optional for Texas agencies.
Common Texas exceptions include: visit time not captured at the point of care; GPS location outside the approved service address; attendant not matching the MCO's attendant of record; visit outside the active STAR+PLUS authorization period; service code mismatch between the HHAeXchange record and the MCO authorization; and overlapping visit records across MCOs. Under hard-edit enforcement, unresolved exceptions result in automatic TMHP denial.
Texas agencies typically contract with multiple STAR+PLUS MCOs — each with its own authorization periods, reauthorization processes, and claim submission timelines. EVV requirements are consistent (all flow to TMHP), but each MCO's submission window differs. Under hard-edit enforcement, an exception that would still be workable under one MCO's timeline may already be past the deadline for another — and both result in auto-denial at TMHP. Multi-MCO operations require automated exception tracking by plan, not a single queue.
Most STAR+PLUS and STAR Kids MCOs require HHAeXchange as their EVV portal. However, MCO-level requirements can vary, and agencies should verify the specific EVV system requirement directly with each plan they contract with. All plans ultimately require that EVV data reach TMHP — the method of getting it there may differ by MCO. Confirming per-plan requirements before your first claim submission is essential, as using the wrong portal creates an unmatched TMHP record.
CareBravo handles EVV compliance as part of its operational delivery, including the multi-MCO complexity specific to Texas. Point-of-care verification, HHAeXchange submission, exception resolution, and TMHP transmission tracking are managed on each MCO's timeline — not queued for your team to work. Authorization tracking across multiple STAR+PLUS plans is maintained continuously so that visit records match authorization windows before the TMHP submission window closes. Your team doesn't manage HHAeXchange exception queues across multiple MCO timelines.
Most Texas agencies lose more to authorization drain — unused STAR+PLUS hours across multiple MCO authorization periods — than to EVV exceptions alone. The CareDrain Diagnostic puts a dollar figure on all three vectors for your agency's specific size and payer mix.