Revisions

20-2, Changes to Section 1614, Section 3200, Section 3327.1, Section 3410, Section 4300, Section 4400 and Section 5212

Revision Notice 20-2; Effective September 1, 2020

 

The following change(s) were made:

Revised Title Change
1614 When and What Information May Be Disclosed Adds a link to an online question and complaint form.
3200 Member Reassessment Adds a requirement to submit the Individual Service Plan (ISP) tracking tool to the LTC Portal upon reassessment.
3327.1 Process for Reviewing the Individual Service Plan Expiring Report Removes Program Support Unit (PSU) processes and updates managed care organization (MCO) requirements for how to retrieve and use the report.
3410 Transfer from One Managed Care Organization to Another Updates how members may request an MCO transfer. Adds headings throughout the section for clarity. Updates the requirements for both the gaining and losing MCO. Updates the time frames to provide information.
4300 Private Duty Nursing Updates the section to match MCO notice guidance. The MCO must follow the Texas Medicaid Provider Procedure Manual (TMPPM) guidance for private duty nursing. Removes all other language as the information is in the TMPPM. Moves Section 4330 to 4310 and deletes Sections 4311 and 4320.
4400 Prescribed Pediatric Extended Care Centers Updates references, citations and information to match TMPPM guidance. Changes the flow of information for reading and ease of use, adding Section 4411 and moving information previously in 4411 to 4412.
5212 Services Available in the CDS Option Changes the title of the section and adds information based on House Bill 4533 services available in the Medically Dependent Children Program (MDCP) Waiver under the Consumer Directed Services (CDS) Option.

20-1, Changes to Section 2030, Section 5000, Form 2601, Form 2601-S and Instructions

Revision Notice 20-1; Effective March 16, 2020

 

The following change(s) were made:

Revised Title Change
2030 Managed Care Organization Coordination Updates time limits for activities, clarifies the process for obtaining the physician signature on Form 2601, Physician Certification, and completing Form 2603, Individual Service Plan, and clarifies how to proceed when the managed care organization experiences a delay in the completion of activities within the specified timeline.
5000 Service Delivery Options Updates service delivery options for Consumer Directed Services, the Service Responsibility Option and agency option.
Form 2601, Form 2601-S and Instructions Physician Certification Adds two questions for the physician to answer to certify a need for ongoing services.

19-2, Miscellaneous Changes

Revision Notice 19-2; Effective December 2, 2019

 

The following change(s) were made:

Revised Title Change
Section 4910 Employment Assistance Removes “waiver” from Medically Dependent Children Program services and clarifies a member who has been referred for Texas Workforce Commission (TWC) or contacted TWC himself is eligible to receive employee assistance (EA).
Section 6140 Unable to Obtain Physician Signature Adds a new section.

19-1, Miscellaneous Changes

Revision Notice 19-1; Effective June 3, 2019

 

The following change(s) were made:

Revised Title Change
Section 1000 Overview and Eligibility Removes Program Support Unit (PSU) language and clarifies other language.
Section 2000 Medically Dependent Children Program Intake and Initial Application Removes PSU language; clarifies other language; updates PSU procedures for individuals in a limited nursing home stay in Sections 2131 and 2132; and updates Form 3618 procedures in Section 2134.
Section 3000 STAR Kids Screening and Assessment and Service Planning Removes PSU language and clarifies other language.
Section 4000 STAR Kids Community Services Removes PSU language and clarifies other language.
Section 5000 Service Delivery Options Removes PSU language and clarifies other language.
Section 8000 Utilization Management and Review by the State Changes Section 8100 title and clarifies language.
Appendix V STAR Kids Acronyms Adds a new appendix.
Appendix IX STAR Kids TxMedCentral Naming Conventions Changes title, replaces “Plan ID” with “Plan Code” and clarifies language.
Appendix XI STAR Kids Plan Codes Adds a new appendix.