KodaComplyHome care rules, state by state, in plain EnglishDocuments collected September 22, 2026

Tennessee home care rules

Tennessee's Health Facilities Commission (HFC) licenses home health and other home care organizations, and agencies that give personal support services need a license from the Department of Disability and Aging (DDA) or the Department of Mental Health and Substance Abuse Services (DMHSAS). TennCare's three health plans (BlueCare, UnitedHealthcare and Wellpoint) pay for CHOICES and ECF CHOICES home care, while DDA runs the three 1915(c) waivers. New since July 1, 2026: members can self-direct health care tasks, such as giving medicines, through aides at agencies that opt in.

107 official documents·collected September 22, 2026·checked against them September 22, 2026
License for non-medical home care?Yes, for personal supportPersonal Support Services Agency (PSSA) license from DDA or DMHSAS, depending on who most of your clients are. Homemaker-only service does not need an HFC home care organization license, but DDA's rules count household help as a personal support service.
License for home health?Yes, plus a CONHome care organization license from HFC · renewed yearly · $1,404 fee. A Certificate of Need (CON) comes first, except for pediatric-only or EEOICPA-only agencies.
EVVRequiredHome health, private duty nursing, and CHOICES and ECF CHOICES home and community based services. Use the member's health plan system or a linked vendor; TennCare's home health memos name Sandata (BlueCare) and CareBridge (UnitedHealthcare, Wellpoint).
Medicaid health plans3 plansBlueCare, UnitedHealthcare, Wellpoint. TennCare Select is a separate state-backed plan, set up as a backup and for certain groups, such as children in state custody.

What changed, and what to do about it

Red means act now, amber means read it this month, grey is for the record.

Read this monthProtocol effective July 1, 2026 · FAQ undated

Members can now self-direct health care tasks through agency aides, if your agency opts in

TennCare's protocol, citing state law (Tenn. Code Ann. § 71-5-1414), lets members in CHOICES, ECF CHOICES, the 1915(c) waivers and Katie Beckett direct and supervise a paid aide doing certain health care tasks, such as giving medicines. Taking part is optional for agencies. Agencies opt in through a survey the plans or DDA run twice a year. TennCare's FAQ says there is no additional payment on top of the service rate. PSSA agencies licensed by DMHSAS need a waiver from DMHSAS.

What to do: Decide whether to opt in. If you do, list any tasks you will not do, and keep each aide's training attestation in their employee file.
Read this monthEffective October 1, 2025

New training protocol for home and community based services staff

TennCare's LTSS Training Operational Protocol sets onboarding, pre-service (30 days) and core (60 days) training for staff in the 1915(c) waivers, ECF CHOICES and Katie Beckett. CHOICES-only agencies must give initial and ongoing training on listed topics, including EVV, and the health plans check this at credentialing and recredentialing.

What to do: Check your onboarding tracker against the protocol's deadlines before your next credentialing review.
For the recordLast updated March 16, 2026

DDA updated its Reportable Event Management protocol

The protocol covers CHOICES, ECF CHOICES, Katie Beckett, the 1915(c) waivers and ICF/IID. Tier 1 events go to the DDA Abuse Hotline within 4 hours, with a Reportable Event Form within 1 business day. Tier 2 events need a Reportable Event Form within 1 business day.

What to do: Make sure your Event Management Coordinator is working from the March 16, 2026 version.
For the recordTennCare memo, Sept. 24, 2025

EVV when a member has other insurance

Medicare crossover claims are excluded from EVV. When commercial insurance pays first and TennCare second, the health plans pay their contracted rate and then recover from the other insurer, until TennCare announces a lasting fix. You still record the visit in EVV.

What to do: Keep recording every visit in EVV, even when another insurer pays first.

Deadlines coming up

Dates taken from the rules and notices as we read them.

99days
December 31, 2026

Current TennCare health plan contract period ends

Section B.1 of the statewide contract (Amendment 25) runs January 1, 2014 to December 31, 2026. We do not hold a document on what follows.

100days
January 1, 2027

Faster prior authorization decisions from health plans

From January 1, 2027, when the plans' prior authorization API is due to go live, standard requests must be decided within 7 calendar days and urgent requests within 72 hours.