Revisions
24-1, Miscellaneous Changes
Revision Notice 24-1; Effective Feb. 22, 2024
The following sections were revised in the STAR+PLUS Program Support Unit Operational Procedures Handbook:
Section | Title | Change |
---|---|---|
1410 | MCO Service Coordination for Nursing Facilities | Deletes section. |
1420 | MCO Service Coordination for Programs Serving Members with IDD | Deletes section. |
1430 | MCO Service Coordination for HCBS - Adult Mental Health Program | Deletes section. |
1440 | MCO Service Coordination for the Section 811 Project Rental Assistance Program | Deletes section. |
1450 | MCO Service Coordination for and the Medicaid for Breast and Cervical Cancer Program | Deletes section. |
3316 | Transfer from Another Medicaid Waiver Program to the STAR+PLUS HCBS Program | Adds start of care date for Form H2065-D. Updates ERS email contents. |
3317 | Non-STAR+PLUS Individual Transitioning to the Community with STAR+PLUS HCBS Program | Adds termination date for Form H2065-D and updates ERS email contents. Clarifies PSU coordination is only required for IDD waiver programs. |
4112 | MCO Contracting Options | Updates section title to Reserved for Future Use. Removes policy language. |
4170 | Significant Changes | Updates section title to Reserved for Future Use. Removes policy language. |
5131 | Identifying Managed Care Members in TIERS | Removes MMP and STAR+PLUS plan codes. |
5310 | Using the TMHP Long Term Care Online Portal | Adds language that MCOs do not upload amended ISPs to the MCOHub. |
6300.6 | Unable to Locate | Adds policy on processing upgrade denials. |
6300.10 | Other Reasons | Adds policy that supervisor approval is not required for denials if the applicant is under 21. |
6400 | Disenrollment Request Policy | Adds policy for failure to pay R&B and copayment. |
7210 | Timely or Non-timely State Fair Hearing Request | Adds policy for entering an appeal in TIERS. Clarifies the fair hearings officer determines if there is good cause for non-timely appeal requests. |
7212 | DER Procedures for Entering State Fair Hearing Request | Adds policy for creating and documenting fair hearing requests. |
8200 | Nursing Services | Updates section title to Reserved for Future Use. Removes policy language. |
8210 | Nursing Services | Removes section title and policy language. |
10100 | Long Term Services and Supports | Removes section title and policy language. |
10111 | DAHS Limitations | Removes section title and policy language. |
10120 | Day Activity and Health Services Providers | Removes section title and policy language. |
10130 | Assessment for Day Activity and Health Services | Removes section title and policy language. |
10140 | Reassessment for Day Activity and Health Services | Removes section title and policy language. |
10150 | Authorization for Day Activity and Health Services | Removes section title and policy language. |
10160 | Reauthorization | Removes section title and policy language. |
10170 | Transfer Between Facilities | Removes section title and policy language. |
10180 | Transfer Between Managed Care Organizations | Removes section title and policy language. |
10181 | Gaining MCO in Same Service Area | Removes section title and policy language. |
10182 | Gaining MCO in Different Service Area | Removes section title and policy language. |
Appendix XXIX | STAR+PLUS Plan Codes | Updates section title to STAR+PLUS Plan Codes. Adds STAR+PLUS and MMP plan codes. |
23-4, Miscellaneous Changes
Revision Notice 23-4; Effective Dec. 7, 2023
The following sections were revised in the STAR+PLUS Program Support Unit Operational Procedures Handbook:
Section | Title | Change |
---|---|---|
3239 | Copayment Changes | Adds clarifying language on copayment begin dates and adverse action. |
3313 | Termination of CCSE Services Upon STAR+PLUS HCBS Program Enrollment | Corrects email subject lines. |
3316 | Requests for STAR+PLUS HCBS Program from an Individual in 1915(c) Medicaid Waiver | Updates section title to “Transfer from Another Medicaid Waiver Program to the STAR+PLUS HCBS Program” and adds clarifying language. |
3317 | Transfer from STAR+PLUS HCBS Program to Another Medicaid Waiver Program | Adds clarifying language on actions taken in the TMHP LTCOP. |
3421.2 | Nine Months Prior to the Member’s 21st Birthday | Removes use of Form H3675. |
3514.1 | STAR+PLUS Individual Transitioning to the Community with STAR+PLUS HCBS Program | Updates PSU staff timeframes to complete case actions from two business days to five business days. |
3515.1 | Non-STAR+PLUS Individual Transitioning to the Community with STAR+PLUS HCBS Program | Updates PSU staff timeframes to complete case actions from one business day to five business days. |
6300.1 | Death | Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines. |
6300.2 | Institutional Stay | Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines. |
6300.3 | Voluntarily Declined Services | Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines. |
6300.5 | Medical Necessity and Level of Care | Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines. |
6300.6 | Unable to Locate | Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines. |
6300.7 | Exceeding the ISP Cost Limit | Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines. |
6300.8 | Failure to Obtain Physician’s Signature | Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines. |
6300.9 | Failure to Meet Other Program Requirements | Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines. |
6300.10 | Other Reasons | Adds clarifying language on actions taken in the TMHP LTCOP and SASO and correct email subject lines. |
Appendix III | Medicaid Type Program Codes for STAR+PLUS HCBS Program and CFC | Adds clarifying language for Earnings Transitional and TANF Medicaid types. |
Appendix IV | Form H2065-D STAR+PLUS HCBS Program Reason for Denial and Comments Language | Adds HCBS-AMH to waiver transfer denial reason. |
Appendix XXVII | PSU Users H1700 ISP Form User Guide | Adds new linked user guide. |
Appendix XXXIII | STAR+PLUS HEART Naming Conventions | Adds TIERS copayment budget screenshot. |
Glossary | Glossary | Adds new terms for AFC, ALF, and HCBS-AMH. |
23-3, Miscellaneous Changes
Revision Notice 23-3; Effective Aug. 21, 2023
The following sections were revised in the STAR+PLUS Program Support Unit Operational Procedures Handbook:
Section | Title | Change |
---|---|---|
1521.1 | Phone Communication | Adds clarifying language on Form H1826.Updates title . |
1530 | Information That May Be Disclosed | Adds clarifying language on Form H1826. |
3317 | Requests for a 1915(c) Medicaid Waiver from a STAR+PLUS HCBS Program Member | Adds new section and policy language. |
3520 | Money Follows the Person Demonstration Entitlement Period Tracking | Updates section title to “Money Follows the Person Demonstration.” Removes policy language. |
3521 | Money Follows the Person Demonstration Introduction | Adds new section and policy language. |
3522 | Screening Criteria for Money Follows the Person Demonstration Eligibility | Adds new section and policy language. |
3522.1 | Screening for 60-Day Qualifying Institutional Stay | Adds new section and policy language. |
3522.2 | Program Support Unit Staff Verification of 60-Day Qualifying Institutional Stay | Adds new section and policy language. |
3523 | Enrollment in Money Follows the Person Demonstration | Adds new section and policy language. |
3524 | Money Follows the Person Demonstration Entitlement Period Tracking | Adds new section and policy language. |
3623.1 | Upgrades and Interest List Releases | Adds clarifying language on MCO resubmissions of MN/LOC Assessments. |
5230 | MFPD Entitlement Tracking and SASO Data Entry | Adds clarifying language. |
5310 | Using the TMHP Long Term Care Online Portal | Adds clarifying language on MCO resubmissions of MN/LOC Assessments. |
7211 | PSU Staff Procedures for Completing Form 4800-D | Updates TIERS data entry for SSI fair hearings and procedures for completing Form 4800-D. |
7221.3 | Supplemental Security Income Denial by the Social Security Administration | Updates TIERS data entry for SSI fair hearings. |
7400 | State Fair Hearing Decision Actions | Adds fair hearing decision definitions. |
9480 | STAR+PLUS HCBS Program and Nursing Facility Overlap Report | Adds clarifying language. |
Appendix I-D | Type of Denials | Updates section title to “Reserved for Future Use”. Removes policy language. |
Appendix XXII | HHSC Benefits Portal and TIERS Inquiry Desk Guide | Adds supporting documents. |
Appendix XXXIII | STAR+PLUS HEART Naming Conventions | Adds MFPD Reporting Coordinator email naming convention. |
23-2, Miscellaneous Changes
Revision Notice 23-2; Effective May 15, 2023
Revisions
The following sections were revised in the STAR+PLUS Program Support Unit Operational Procedures Handbook:
Section | Title | Change |
---|---|---|
3230 | Financial Eligibility | Adds Form 2606 references and removes Form H2065-D denial reason language. |
3232 | Payments from the Qualified Income Trust | Updates Form H1700 references. |
3237 | Determining Room and Board Charges | Removes personal needs allowance language. |
3238 | Determining Copayment Amounts | Adds personal needs allowance language. |
3311.2 | Enrollment Procedures Following Release from the Interest List | Updates PSU staff time frame to three business days for uploading Form H3676, updates Form H1700 references. Adds clarifying language for PAS and ERS. Adds PSORT mailbox for initial non-compliances. |
3421.5 | Within 45 Days of Receiving Form H3676 Referral | Updates section title to “MCO Actions After Receiving Form H3676 Referral,” Form H1700 references and MN expiration date. |
3421.6 | Confirm STAR+PLUS HCBS Program Eligibility | Updates Form H1700 references. Clarifies the assessment type required if an MN determination expires. |
3421.7 | ISP Cost Exceeds 202% of the RUG Cost Limit | Removes Form H1700 references and adds clarifying language. |
3513 | Applications Pending More than Four Calendar Months Due to Delay in NF Discharge | Adds clarifying language. |
3610 | Revising the Individual Service Plan | Updates Form H1700 references and adds clarifying language. |
4171 | Termination of AFC Services | Removes section title and policy language. |
4172 | Discharge and Termination Due to Health and Safety | Removes section title and policy language. |
4222 | Initial Responsibilities for Applicants or Members Residing in ALFs | Updates section title to “Reserved for Future Use” and removes policy language. |
4224 | Personal Care 3 | Updates section title to “Reserved for Future Use” and removes policy language. |
4245 | Termination Due to Failure to Pay Required Contribution to the Cost of Care | Updates section title to “Reserved for Future Use” and removes policy language. |
4260 | Staffing and Training Requirements | Updates section title to “Reserved for Future Use” and removes policy language. |
4274 | Vendor Receipts | Updates section title to “Reserved for Future Use” and removes policy language. |
4275 | Group Purchases | Updates section title to “Reserved for Future Use” and removes policy language. |
4260 | Staffing and Training Requirements | Updates section title to "Reserved for Future Use" and removes policy language. |
4278 | Refunds to Discharged or Deceased Members | Removes section title and policy language. |
4430 | ERS Member Eligibility | Removes language related to the MCO not entering ERS and PAS on the ISP for MAO members. |
4690 | Member Notifications and Appeals | Removes section title and policy language. |
6300.10 | Other Reasons | Adds miscellaneous updates. |
7214 | State Fair Hearing Packet | Adds Form 4801 references. |
7222.2 | Termination of STAR+PLUS HCBS Program Due to Member Not Requesting a State Fair Hearing | Updates section title to “Discontinuation of STAR+PLUS HCBS Program Due to Member Not Requesting a State Fair Hearing”. Adds clarifying language. |
7420 | Reversed State Fair Hearing Decision | Updates PSU staff timeframe for generating Form H2065-D and adds clarifying language. |
8114 | Individual Service Plan | Updates Form H1700 references and adds clarifying language. |
8115 | Individual Agreement for Services | Updates section title to “Reserved for Future Use” and removes policy language. |
8116 | Refusal to Serve Members | Updates section title to “Reserved for Future Use” and removes policy language. |
8117 | Service Planning | Updates section title to “Reserved for Future Use” and removes policy language. |
8118 | Personal Assistance Services | Adds clarifying language for PAS and ERS. |
9310 | Transfers from One STAR+PLUS Area to Another Area | Updates gaining PSU staff actions and adds clarifying language. |
Appendix IV | Form H2065-D STAR+PLUS HCBS Program Reason for Denial and Comments Language | Adds denial reason and comments language. |
Appendix XXI | Reserved for Future Use | Updates section title to “Creating an Appeal in TIERS” and includes instruction for data entry on fair hearing request. |
Appendix XXXIII | STAR+PLUS HEART Naming Conventions | Updates and adds HEART naming conventions. |
Appendix XXVIII | Reserved for Future Use | Updates section title to “County Codes and City and County List” and includes a table of SASO codes. |