Changing Provider Information

Each information type has a different process for changing, including timelines for submitting a change. Visit the TULIP website to access the forms to make changes to your information.

Changes in Physical Location or Mailing Address

An HCSSA must not transfer a license from one location to another without prior notice to HHS. Changes in a physical address must be submitted in writing no later than 30 days before the effective date of the change, unless HHS grants the HCSSA an exemption from the 30-day time frame as specified in 26 TAC §558.213(b).

Changes in Phone Number or Operating Hours

Changes in phone number or operating hours must be submitted in writing no later than seven days after the change.

Fax Number and Email Address

Report as soon as possible.

Change in HCSSA Name

If a HCSSA intends to change its name (legal entity or doing business as) but does not undergo a change of ownership, the HCSSA must report the name change no later than seven days after the effective date of the name change. Attach copies of the legal documents pertaining to legal entity or doing business as change.

Change in Certification Status

If a HCSSA decides to voluntarily withdraw from the Medicare program, the HCSSA must notify HHS in writing no later than five days after the decision to withdraw is made. A HCSSA should use HHS Form 2021 to provide written notice.

Changes in Management Personnel

Changes in administrator, alternate administrator or chief financial officer must be submitted in writing no later than seven days after the date of change. Additional documentation might be required.

Changes in Controlling Person

Changes in controlling person (stock transfers) as defined in 26 TAC §558.2 must be submitted in writing no later than seven days after the date of change. Attach copies of the legal and notarized documents pertaining to the stock transfer.

Adding or Deleting Service Categories

To add or delete a category of service to its license, a HCSSA must submit written notice at least 30 days before the addition or deletion of the category of service. Additional documentation is required for adding the categories of home health or hospice.

Expanding or Reducing Service Areas

A HCSSA can expand its service area at any time during the licensure period by submitting written notice at least 30 days before the expansion. A HCSSA can reduce its service area at any time during the licensure period by submitting written notice no later than 10 days after the reduction.

Closures

A HCSSA must notify HHS in writing within five days before the permanent closure of the HCSSA, branch office or alternate delivery site.