4/16/2023 0 Comments Passport timely filingThis is described in the Texas Medicaid State Plan and the Texas Medicaid Provider Procedure Manual (TMPPM)through the member’s selected managed care organization (MCO). STAR Kids members are entitled to all medically and functionally necessary services available in the same amount, duration and scope as in traditional fee-for-service Medicaid. achieve cost efficiency and cost containment.ġ200, STAR Kids Services and Service Delivery Options.prepare young adults for the transition to adulthood.improve member outcomes to the greatest extent achievable.improve provider collaboration and integration of different services.improve ease of program participation for members, managed care organizations and providers.improve access to care and provide person-centered health homes.improve quality, continuity and customization of care.To achieve HHSC’s mission, the STAR Kids program is established to: The Texas Health and Human Services Commission (HHSC) mission is to provide individualized and appropriate Medicaid managed care services to children and young adults with disabilities to enable them to live and thrive in a setting that maximizes their health, safety and overall well-being. The STAR Kids Handbook includes policies and procedures to be used by all Texas Health and Human Services (HHS) agencies, and the contractors and providers in the delivery of STAR Kids Program services to eligible members. Requirements pertaining to managed care organizations (MCOs) are outlined in the STAR Kids Managed Care Contract and in this handbook. Texas Administrative Code, Title 1, Part 15, Chapter 353, Subchapter M, Home and Community Based Services in Managed Care, and Subchapter N, STAR Kids, outline the delivery of Medically Dependent Children Program services (MDCP), as well as the STAR Kids program. STAR Kids Medicaid Managed Care Program is required by Texas Government Code, § 533.00253. Revision 22-2 Effective September 1, 2022 A child, young adult, or LAR may ask their MCO about how to be placed on the MDCP interest list at any time. The number of program slots is limited by legislative appropriations, so HHSC maintains an interest list for MDCP. MDCP provides respite, flexible family support services, adaptive aids, minor home modifications, employment services and transition assistance to children and young adults who meet the level of care provided in a nursing facility (NF), so they can safely live in the community. MDCP is a home and community-based services program authorized and operated concurrently by Sections 1915(c) and 1115 of the Social Security Act. In addition to traditional Medicaid services, STAR Kids MCOs are responsible for delivering other services to children enrolled in the Medically Dependent Children Program (MDCP). The MCO must also reassess the member, revise their ISP, as applicable, and authorize necessary services upon request of the member, LAR, or health home. Within the time frame listed in the STAR Kids Contract, if a member has a significant change in condition, the MCO must reassess the member, update their individual service plan (ISP), as applicable, and authorize medically or functionally necessary services. This is done by a service coordinator using the STAR Kids Screening and Assessment Instrument (SK-SAI ). coordination of Medicaid benefits with non-Medicaid services and supports, as necessary and appropriate.Īll STAR Kids members receive a comprehensive assessment of their physical and functional needs annually.attention to addressing unique needs of members and.assistance to ensure timely and a coordinated access to an array of providers and services.identification and addressing of needs, including physical health, behavioral health services, and LTSS with development of an individual service plan (ISP).Service coordination is specialized care management performed by a service coordinator and includes but is not limited to: All STAR Kids members have access to service coordination, provided by an MCO employee or through a member's primary care provider. Children and young adults, birth through 20, enrolled in a STAR Kids MCO are called members of the MCO. STAR Kids does change the way in which services are delivered. STAR Kids does not change or affect an individual's Medicaid eligibility or impact access to Medicaid services and supports. STAR Kids is a Medicaid managed care program for children with disabilities in Texas, which integrates acute care and long-term services and supports (LTSS) delivered by a managed care organization (MCO). Texas Government Code Section 533.00253 required the Texas Health and Human Services Commission (HHSC) to create the State of Texas Access Reform (STAR) Kids program.
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