Revisions
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:
Section | Title | Change |
---|---|---|
1220 | Long Term Services and Supports | Amends language for clarification purposes. Updates the definition of attendant care services. |
2132 | MCO Coordination Procedures for an MDCP Applicant Approved for a Limited NF Stay | Amends 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”. |
3200 | Member Reassessment | Removes an incorrect reference to Community First Choice (CFC). Removes the word “service coordinator” from mentions of “MCO service coordinator”. |
3511 | STAR+PLUS Transition Activities | Updates link to STAR+PLUS Handbook. |
5311 | Developing the Individual Service Plan in the CDS Option | Updates 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”. |
7200 | External Medical Review | Amends language around the external medical review (EMR) process. |
7612 | Reversed Appeal Decisions | Updates language around PSU procedures for reversed appeal decisions. |
Form 2603 Instructions | Form 2603, STAR Kids Individual Service Plan (ISP) Narrative | Revises 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:
Section | Title | Change |
---|---|---|
1311 | Member Refusal to Participate in Service Coordination | Changes reference from TxMedCentral to MCOHub. |
1630 | Communication with the Managed Care Organization | Changes reference from TxMedCentral to MCOHub. |
1810 | Program Support Unit Notification Requirements | Changes reference from TxMedCentral to MCOHub. |
2030 | Managed Care Organization Coordination | Changes reference from TxMedCentral to MCOHub. |
2111 | Non-STAR Kids Individual Residing in an NF | Changes reference from TxMedCentral to MCOHub. |
2112 | STAR Kids Member Residing in an NF | Changes reference from TxMedCentral to MCOHub. |
2113 | MDCP MFP Applications Pending Due to Delay in NF Discharge | Changes reference from TxMedCentral to MCOHub. |
2131 | Individual Who is Approved for a Limited NF Stay | Changes reference from TxMedCentral to MCOHub. |
2132 | MCO Coordination Procedures for an MDCP Applicant Approved for a Limited NF Stay | Changes reference from TxMedCentral to MCOHub. |
2133 | Delays in Limited NF Stay for an Applicant Not Enrolled in STAR Kids | Changes reference from TxMedCentral to MCOHub. |
2210 | Medical Necessity Expiration | Changes reference from TxMedCentral to MCOHub. |
2220 | MDCP Start of Care Date for Interest List Releases | Changes reference from TxMedCentral to MCOHub. |
2230 | Member Reassessment | Changes reference from TxMedCentral to MCOHub. |
3200 | Reassessment of Medical Necessity or Level of Care | Changes reference from TxMedCentral to MCOHub. |
3210 | Reassessment of Medical Necessity or Level of Care | Changes reference from TxMedCentral to MCOHub. |
3329 | Reassessment Notification Requirements | Changes reference from TxMedCentral to MCOHub. |
3410 | Transfer from One Managed Care Organization to Another | Changes all references to TxMedCentral to MCOHub |
3420 | Member Transfer from Waiver Program to Medically Dependent Children Program | Changes all references to TxMedCentral to MCOHub |
6200 | Denial/Termination of Medically Dependent Children Program | Changes reference from TxMedCentral to MCOHub. |
6210 | Denial/Termination Due to Death | Changes reference from TxMedCentral to MCOHub. |
6220 | Denial/Termination Due to Residence in a Nursing Facility | Changes reference from TxMedCentral to MCOHub. |
6270 | Denial/Termination Due to Failure to Meet Other Program Requirements | Changes reference from TxMedCentral to MCOHub. |
6280 | Denial/Termination for Other Reasons | Changes reference from TxMedCentral to MCOHub. |
7510 | Continuation of Medically Dependent Children Program Waiver Services During a State Fair Hearing | Changes reference from TxMedCentral to MCOHub. |
7520 | Discontinuation of Medically Dependent Children Program Waiver Services During a State Fair Hearing | Changes reference from TxMedCentral to MCOHub. |
7800 | Community First Choice State Fair Hearing | Changes reference from TxMedCentral to MCOHub. |
Appendix IX | Star Kids TxMedCentral Naming Conventions | Changes reference from TxMedCentral to MCOHub. |
Glossary | Glossary | Changes 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:
Section | Title | Change |
---|---|---|
Appendix III | LTSS Billing Matrix and Crosswalk | Updates 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. |