Filter by content type:

Form H2067-MC, Managed Care Programs Communication
... communication tool for Program Support Unit (PSU) and managed care organization (MCO) staff to inform one another on ... form according to the retention requirements found in all Medicaid managed care contracts and federal regulations. MCOs ...

Section 9000, Fraud, Waste and Abuse
... you are made aware of, or suspect situations that may be Medicaid fraud, waste or abuse please report it to the HHSC ... information for HHSC approved EVV vendors, payers and managed care organizations. HHSC-Approved EVV Vendors DataLogic ...

STAR+PLUS Expansion
Most people covered by Medicaid who are older or who have a disability now get their ... and supports, and service coordination through a STAR+PLUS managed care health plan. Breast and Cervical Cancer Program A new ...

Resources
... CARE Intellectual Disability, MRA User Guide and MRA Data ... https://hhsportal.hhs.state.tx.us/helpGuide/Content/16_CARE/IntellectualDisability.htm CARE JHS/XPTR User Guide and ... Medicaid Estate Recovery Program Guide ... STAR+PLUS Overview https://hhs.texas.gov/services/health/medicaid-chip/programs/starplus Targeted Case Management ...

Section 5000, Automation and Payment Issues in STAR+PLUS
... the Texas Health and Human Services Commission (HHSC) and managed care organizations (MCOs) use to share information. ... Plan Identification (ID) Form Number (#) Member ID, Medicaid # or Social Security Number (SSN) Member Last Name ...

Section 5000, Automation and Payment Issues in STAR+PLUS HCBS Program
... (PSU) staff must electronically back up documents from the managed care organization’s (MCO’s) ISP and SPW folder on a daily ... in TIERS. Program Support Unit (PSU) staff must inform the Medicaid for the Elderly and People with Disabilities (MEPD) ...

Section 3000, STAR+PLUS HCBS Program Eligibility and Services
... Revision 18-0; Effective September 4, 2018     3110 Medicaid, Medicare and Dual-Eligible Members Revision 18-0; ... dual-eligible members. Dual eligible members choose a managed care organization (MCO), but are not required to choose a ...

Section 3000, STAR+PLUS HCBS Program Eligibility and Services
... Revision 18-2; Effective September 3, 2018     3110 Medicaid, Medicare and Dual-Eligibles Revision 18-2; ... Members Revision 19-1; Effective June 3, 2019   Managed care organizations (MCOs) are required to contact all members ...

Section 6000, Service Delivery Options
... 6400 , State of Texas Access Reform Plus (STAR+PLUS) Managed Care. No special procedures are necessary for the AO. Consult ... and Supports. The STAR+PLUS program does not change Medicaid eligibility or services. It changes the way Medicaid ...

Form 6501, Individual Program Plan
... required service category on Form 6500, Individual Plan of Care (IPC)-DBMD.   Procedure When to Prepare The case ... period as it appears on the individual's IPC (Form 6500). Medicaid Number  -- Enter the individual's nine-digit ... routine preventive treatment and/or emergency treatment. Managed Care Organizations (MCOs) value added services do not ...