23-4, Sections 1220, 2132, 3200, 3511, 5311, 7200, 7612, Form 2603 Instructions Revised

Revision Notice 23-4; Effective Dec. 1, 2023

The following change(s) were made:

SectionTitleChange
1220Long Term Services and SupportsAmends language for clarification purposes. Updates the definition of attendant care services.
2132MCO Coordination Procedures for an MDCP Applicant Approved for a Limited NF StayAmends language for clarification purposes. Updates instructions for MCOs around limited nursing facility (NF) stay. Removes the word “service coordinator” from mentions of “MCO service coordinator”.
3200Member ReassessmentRemoves an incorrect reference to Community First Choice (CFC). Removes the word “service coordinator” from mentions of “MCO service coordinator”.
3511STAR+PLUS Transition ActivitiesUpdates link to STAR+PLUS Handbook.
5311Developing the Individual Service Plan in the CDS OptionUpdates instructions for completing denials, reductions in services and suspensions. Updates instructions in the Consumer Directed Services (CDS) option for a registered nurse (RN). Removes the word “service coordinator” from mentions of “MCO service coordinator”.
7200External Medical ReviewAmends language around the external medical review (EMR) process.
7612Reversed Appeal DecisionsUpdates language around PSU procedures for reversed appeal decisions.
Form 2603 InstructionsForm 2603, STAR Kids Individual Service Plan (ISP) NarrativeRevises instructions for when to prepare or update Form 2603. Provides clarification on documenting changes to services on the individual service plan (ISP) and provides clarification for when changes can be made.

23-3, Changes TexMedCentral Reference to MCOHub Throughout Handbook

Revision Notice 23-3; Effective July 21, 2023

The following change(s) were made:

SectionTitleChange
1311Member Refusal to Participate in Service CoordinationChanges reference from TxMedCentral to MCOHub.
1630Communication with the Managed Care OrganizationChanges reference from TxMedCentral to MCOHub.
1810Program Support Unit Notification RequirementsChanges reference from TxMedCentral to MCOHub.
2030Managed Care Organization CoordinationChanges reference from TxMedCentral to MCOHub.
2111Non-STAR Kids Individual Residing in an NFChanges reference from TxMedCentral to MCOHub.
2112STAR Kids Member Residing in an NFChanges reference from TxMedCentral to MCOHub.
2113MDCP MFP Applications Pending Due to Delay in NF DischargeChanges reference from TxMedCentral to MCOHub.
2131Individual Who is Approved for a Limited NF StayChanges reference from TxMedCentral to MCOHub.
2132MCO Coordination Procedures for an MDCP Applicant Approved for a Limited NF StayChanges reference from TxMedCentral to MCOHub.
2133Delays in Limited NF Stay for an Applicant Not Enrolled in STAR KidsChanges reference from TxMedCentral to MCOHub.
2210Medical Necessity ExpirationChanges reference from TxMedCentral to MCOHub.
2220MDCP Start of Care Date for Interest List ReleasesChanges reference from TxMedCentral to MCOHub.
2230Member ReassessmentChanges reference from TxMedCentral to MCOHub.
3200Reassessment of Medical Necessity or Level of CareChanges reference from TxMedCentral to MCOHub.
3210Reassessment of Medical Necessity or Level of CareChanges reference from TxMedCentral to MCOHub.
3329Reassessment Notification RequirementsChanges reference from TxMedCentral to MCOHub.
3410Transfer from One Managed Care Organization to AnotherChanges all references to TxMedCentral to MCOHub
3420Member Transfer from Waiver Program to Medically Dependent Children ProgramChanges all references to TxMedCentral to MCOHub
6200Denial/Termination of Medically Dependent Children ProgramChanges reference from TxMedCentral to MCOHub.
6210Denial/Termination Due to DeathChanges reference from TxMedCentral to MCOHub.
6220Denial/Termination Due to Residence in a Nursing FacilityChanges reference from TxMedCentral to MCOHub.
6270Denial/Termination Due to Failure to Meet Other Program RequirementsChanges reference from TxMedCentral to MCOHub.
6280Denial/Termination for Other ReasonsChanges reference from TxMedCentral to MCOHub.
7510Continuation of Medically Dependent Children Program Waiver Services During a State Fair HearingChanges reference from TxMedCentral to MCOHub.
7520Discontinuation of Medically Dependent Children Program Waiver Services During a State Fair HearingChanges reference from TxMedCentral to MCOHub.
7800Community First Choice State Fair HearingChanges reference from TxMedCentral to MCOHub.
Appendix IXStar Kids TxMedCentral Naming ConventionsChanges reference from TxMedCentral to MCOHub.
GlossaryGlossaryChanges reference from TxMedCentral to MCOHub. Relocates MCOHub to the M section of the glossary for alphabetical order.

23-2, Updates Appendix III

Revision Notice 23-2; Effective July 7, 2023

The following change(s) were made:

SectionTitleChange
Appendix IIILTSS Billing Matrix and CrosswalkUpdates billing matrix. Adds clarifying language and corrects a revenue code.

23-1, Adds Appendix XIV

Revision Notice 23-1; Effective March 1, 2023

The following change(s) were made:

Section Title Change
Appendix XIV Home and Community-Based Services Settings Rule Creates new appendix for the Home and Community-Based Services Settings Rule.