Revisions

24-1, Miscellaneous Changes

Revision Notice 24-1; Effective Feb. 22, 2024

The following sections were revised in the STAR+PLUS Program Support Unit Operational Procedures Handbook:

Section	Title	Change
1410	MCO Service Coordination for Nursing Facilities	Deletes section.
1420	MCO Service Coordination for Programs Serving Members with IDD	Deletes section.
1430	MCO Service Coordination for HCBS - Adult Mental Health Program	Deletes section.
1440	MCO Service Coordination for the Section 811 Project Rental Assistance Program	Deletes section.
1450	MCO Service Coordination for and the Medicaid for Breast and Cervical Cancer Program	Deletes section.
3316	Transfer from Another Medicaid Waiver Program to the STAR+PLUS HCBS Program	Adds start of care date for Form H2065-D. Updates ERS email contents.
3317	Non-STAR+PLUS Individual Transitioning to the Community with STAR+PLUS HCBS Program	Adds termination date for Form H2065-D and updates ERS email contents. Clarifies PSU coordination is only required for IDD waiver programs.
4112	MCO Contracting Options	Updates section title to Reserved for Future Use. Removes policy language.
4170	Significant Changes	Updates section title to Reserved for Future Use. Removes policy language.
5131	Identifying Managed Care Members in TIERS	Removes MMP and STAR+PLUS plan codes.
5310	Using the TMHP Long Term Care Online Portal	Adds language that MCOs do not upload amended ISPs to the MCOHub.
6300.6	Unable to Locate	Adds policy on processing upgrade denials.
6300.10	Other Reasons	Adds policy that supervisor approval is not required for denials if the applicant is under 21.
6400	Disenrollment Request Policy	Adds policy for failure to pay R&B and copayment.
7210	Timely or Non-timely State Fair Hearing Request	Adds policy for entering an appeal in TIERS. Clarifies the fair hearings officer determines if there is good cause for non-timely appeal requests.
7212	DER Procedures for Entering State Fair Hearing Request	Adds policy for creating and documenting fair hearing requests.
8200	Nursing Services	Updates section title to Reserved for Future Use. Removes policy language.
8210	Nursing Services	Removes section title and policy language.
10100	Long Term Services and Supports	Removes section title and policy language.
10111	DAHS Limitations	Removes section title and policy language.
10120	Day Activity and Health Services Providers	Removes section title and policy language.
10130	Assessment for Day Activity and Health Services	Removes section title and policy language.
10140	Reassessment for Day Activity and Health Services	Removes section title and policy language.
10150	Authorization for Day Activity and Health Services	Removes section title and policy language.
10160	Reauthorization	Removes section title and policy language.
10170	Transfer Between Facilities	Removes section title and policy language.
10180	Transfer Between Managed Care Organizations	Removes section title and policy language.
10181	Gaining MCO in Same Service Area	Removes section title and policy language.
10182	Gaining MCO in Different Service Area	Removes section title and policy language.
Appendix XXIX	STAR+PLUS Plan Codes	Updates section title to STAR+PLUS Plan Codes. Adds STAR+PLUS and MMP plan codes.

23-4, Miscellaneous Changes

Revision Notice 23-4; Effective Dec. 7, 2023

The following sections were revised in the STAR+PLUS Program Support Unit Operational Procedures Handbook:

Section	Title	Change
3239	Copayment Changes	Adds clarifying language on copayment begin dates and adverse action.
3313	Termination of CCSE Services Upon STAR+PLUS HCBS Program Enrollment	Corrects email subject lines.
3316	Requests for STAR+PLUS HCBS Program from an Individual in 1915(c) Medicaid Waiver	Updates section title to “Transfer from Another Medicaid Waiver Program to the STAR+PLUS HCBS Program” and adds clarifying language.
3317	Transfer from STAR+PLUS HCBS Program to Another Medicaid Waiver Program	Adds clarifying language on actions taken in the TMHP LTCOP.
3421.2	Nine Months Prior to the Member’s 21st Birthday	Removes use of Form H3675.
3514.1	STAR+PLUS Individual Transitioning to the Community with STAR+PLUS HCBS Program	Updates PSU staff timeframes to complete case actions from two business days to five business days.
3515.1	Non-STAR+PLUS Individual Transitioning to the Community with STAR+PLUS HCBS Program	Updates PSU staff timeframes to complete case actions from one business day to five business days.
6300.1	Death	Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines.
6300.2	Institutional Stay	Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines.
6300.3	Voluntarily Declined Services	Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines.
6300.5	Medical Necessity and Level of Care	Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines.
6300.6	Unable to Locate	Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines.
6300.7	Exceeding the ISP Cost Limit	Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines.
6300.8	Failure to Obtain Physician’s Signature	Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines.
6300.9	Failure to Meet Other Program Requirements	Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines.
6300.10	Other Reasons	Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines.
Appendix III	Medicaid Type Program Codes for STAR+PLUS HCBS Program and CFC	Adds clarifying language for Earnings Transitional and TANF Medicaid types.
Appendix IV	Form H2065-D STAR+PLUS HCBS Program Reason for Denial and Comments Language	Adds HCBS-AMH to waiver transfer denial reason.
Appendix XXVII	PSU Users H1700 ISP Form User Guide	Adds new linked user guide.
Appendix XXXIII	STAR+PLUS HEART Naming Conventions	Adds TIERS copayment budget screenshot.
Glossary	Glossary	Adds new terms for AFC, ALF, and HCBS-AMH.

23-3, Miscellaneous Changes

Revision Notice 23-3; Effective Aug. 21, 2023

The following sections were revised in the STAR+PLUS Program Support Unit Operational Procedures Handbook:

Section	Title	Change
1521.1	Phone Communication	Adds clarifying language on Form H1826.Updates title .
1530	Information That May Be Disclosed	Adds clarifying language on Form H1826.
3317	Requests for a 1915(c) Medicaid Waiver from a STAR+PLUS HCBS Program Member	Adds new section and policy language.
3520	Money Follows the Person Demonstration Entitlement Period Tracking	Updates section title to “Money Follows the Person Demonstration.” Removes policy language.
3521	Money Follows the Person Demonstration Introduction	Adds new section and policy language.
3522	Screening Criteria for Money Follows the Person Demonstration Eligibility	Adds new section and policy language.
3522.1	Screening for 60-Day Qualifying Institutional Stay	Adds new section and policy language.
3522.2	Program Support Unit Staff Verification of 60-Day Qualifying Institutional Stay	Adds new section and policy language.
3523	Enrollment in Money Follows the Person Demonstration	Adds new section and policy language.
3524	Money Follows the Person Demonstration Entitlement Period Tracking	Adds new section and policy language.
3623.1	Upgrades and Interest List Releases	Adds clarifying language on MCO resubmissions of MN/LOC Assessments.
5230	MFPD Entitlement Tracking and SASO Data Entry	Adds clarifying language.
5310	Using the TMHP Long Term Care Online Portal	Adds clarifying language on MCO resubmissions of MN/LOC Assessments.
7211	PSU Staff Procedures for Completing Form 4800-D	Updates TIERS data entry for SSI fair hearings and procedures for completing Form 4800-D.
7221.3	Supplemental Security Income Denial by the Social Security Administration	Updates TIERS data entry for SSI fair hearings.
7400	State Fair Hearing Decision Actions	Adds fair hearing decision definitions.
9480	STAR+PLUS HCBS Program and Nursing Facility Overlap Report	Adds clarifying language.
Appendix I-D	Type of Denials	Updates section title to “Reserved for Future Use”. Removes policy language.
Appendix XXII	HHSC Benefits Portal and TIERS Inquiry Desk Guide	Adds supporting documents.
Appendix XXXIII	STAR+PLUS HEART Naming Conventions	Adds MFPD Reporting Coordinator email naming convention.

23-2, Miscellaneous Changes

Revision Notice 23-2; Effective May 15, 2023

Revisions

The following sections were revised in the STAR+PLUS Program Support Unit Operational Procedures Handbook:

Section	Title	Change
3230	Financial Eligibility	Adds Form 2606 references and removes Form H2065-D denial reason language.
3232	Payments from the Qualified Income Trust	Updates Form H1700 references.
3237	Determining Room and Board Charges	Removes personal needs allowance language.
3238	Determining Copayment Amounts	Adds personal needs allowance language.
3311.2	Enrollment Procedures Following Release from the Interest List	Updates PSU staff time frame to three business days for uploading Form H3676, updates Form H1700 references. Adds clarifying language for PAS and ERS. Adds PSORT mailbox for initial non-compliances.
3421.5	Within 45 Days of Receiving Form H3676 Referral	Updates section title to “MCO Actions After Receiving Form H3676 Referral,” Form H1700 references and MN expiration date.
3421.6	Confirm STAR+PLUS HCBS Program Eligibility	Updates Form H1700 references. Clarifies the assessment type required if an MN determination expires.
3421.7	ISP Cost Exceeds 202% of the RUG Cost Limit	Removes Form H1700 references and adds clarifying language.
3513	Applications Pending More than Four Calendar Months Due to Delay in NF Discharge	Adds clarifying language.
3610	Revising the Individual Service Plan	Updates Form H1700 references and adds clarifying language.
4171	Termination of AFC Services	Removes section title and policy language.
4172	Discharge and Termination Due to Health and Safety	Removes section title and policy language.
4222	Initial Responsibilities for Applicants or Members Residing in ALFs	Updates section title to “Reserved for Future Use” and removes policy language.
4224	Personal Care 3	Updates section title to “Reserved for Future Use” and removes policy language.
4245	Termination Due to Failure to Pay Required Contribution to the Cost of Care	Updates section title to “Reserved for Future Use” and removes policy language.
4260	Staffing and Training Requirements	Updates section title to “Reserved for Future Use” and removes policy language.
4274	Vendor Receipts	Updates section title to “Reserved for Future Use” and removes policy language.
4275	Group Purchases	Updates section title to “Reserved for Future Use” and removes policy language.
4260	Staffing and Training Requirements	Updates section title to "Reserved for Future Use" and removes policy language.
4278	Refunds to Discharged or Deceased Members	Removes section title and policy language.
4430	ERS Member Eligibility	Removes language related to the MCO not entering ERS and PAS on the ISP for MAO members.
4690	Member Notifications and Appeals	Removes section title and policy language.
6300.10	Other Reasons	Adds miscellaneous updates.
7214	State Fair Hearing Packet	Adds Form 4801 references.
7222.2	Termination of STAR+PLUS HCBS Program Due to Member Not Requesting a State Fair Hearing	Updates section title to “Discontinuation of STAR+PLUS HCBS Program Due to Member Not Requesting a State Fair Hearing”. Adds clarifying language.
7420	Reversed State Fair Hearing Decision	Updates PSU staff timeframe for generating Form H2065-D and adds clarifying language.
8114	Individual Service Plan	Updates Form H1700 references and adds clarifying language.
8115	Individual Agreement for Services	Updates section title to “Reserved for Future Use” and removes policy language.
8116	Refusal to Serve Members	Updates section title to “Reserved for Future Use” and removes policy language.
8117	Service Planning	Updates section title to “Reserved for Future Use” and removes policy language.
8118	Personal Assistance Services	Adds clarifying language for PAS and ERS.
9310	Transfers from One STAR+PLUS Area to Another Area	Updates gaining PSU staff actions and adds clarifying language.
Appendix IV	Form H2065-D STAR+PLUS HCBS Program Reason for Denial and Comments Language	Adds denial reason and comments language.
Appendix XXI	Reserved for Future Use	Updates section title to “Creating an Appeal in TIERS” and includes instruction for data entry on fair hearing request.
Appendix XXXIII	STAR+PLUS HEART Naming Conventions	Updates and adds HEART naming conventions.
Appendix XXVIII	Reserved for Future Use	Updates section title to “County Codes and City and County List” and includes a table of SASO codes.