1800, PSU Online Database Resources

Revision 19-13; Effective November 5, 2019

The Client Assignment and Registration (CARE) System is an online database used by Program Support Unit (PSU) staff. CARE maintains the enrollment records for the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver programs. PSU staff use CARE to prevent dual enrollment in another Medicaid waiver program.

1820 Community Services Interest List

Revision 19-13; Effective November 5, 2019

Community Services Interest List (CSIL) is an online database used by Interest List Management (ILM) Unit and Program Support Unit (PSU) staff. CSIL maintains an interest list and tracks individuals waiting to receive services for Long Term Services and Supports (LTSS) waiver programs including:

  • Community Living Assistance and Support Services (CLASS);
  • Home and Community-based Services (HCS);
  • Medically Dependent Children Program (MDCP);
  • STAR+PLUS Home and Community Based Services (HCBS) program; and
  • Texas Home Living (TxHmL).

PSU staff use CSIL to verify an individual’s status on the interest list and to prevent dual enrollment in another Medicaid waiver program when an individual is entering the STAR+PLUS HCBS program. PSU staff are required to select the appropriate closure reasons and close the CSIL record when an individual is enrolled in the STAR+PLUS HCBS program.

1830 Health and Human Services Commission Benefits Portal

Revision 19-13; Effective November 5, 2019

The Texas Health and Human Services Commission (HHSC) Benefits portal is an online database used by Program Support Unit (PSU) and Fair Hearings Unit staff. The HHSC Benefits portal maintains state fair hearing documentation, forms and case statuses.

PSU staff use the HHSC Benefits portal to:

  • enter and submit state fair hearing requests;
  • upload state fair hearing documentation and forms;
  • view documents and forms uploaded by the hearings officer; and
  • view the outcome of state fair hearing decisions.

1840 Health and Human Services (HHS) Enterprise Administrative Report and Tracking System

Revision 19-13; Effective November 5, 2019

Texas Health and Human Services (HHS) Enterprise Administrative Report and Tracking System (HEART) is an online database used by Program Support Unit (PSU) staff. HEART is a repository of current and historic case records for applicants and members.

PSU staff use HEART to:

  • review an individual’s, applicant’s or member’s case history;
  • open new case records;
  • update existing case records;
  • upload forms, documents and screenshots;
  • add narratives of case actions;
  • set due date reminders for case actions;
  • track progress on cases;
  • create relationships between case records; and
  • close case records.

PSU staff must search for an individual, applicant or member when any contact or correspondence is received from, or relating to, an individual, applicant or member to determine if there is already a case record open. PSU must open a new case record if one does not already exist.  

For medical assistance only (MAO) individuals and applicants, the patient control number (PCN) field will initially be completed with the individual’s Social Security number (SSN). Once a Medicaid identification (ID) number is assigned to the applicant, PSU staff must update the PCN field to the Medicaid ID number in HEART.

PSU staff will document every case action in the narrative, including telephone calls, mail dates, fax dates, form receipt dates and any other relevant information in the HEART narrative. The HEART documentation should be completed so that someone with no prior knowledge of the case can follow along in HEART and come to the same case action decision. PSU staff must follow the instructions in Appendix XXXIII, STAR+PLUS HEART Naming Conventions, when uploading documents.

PSU staff must close the HEART case record when there is no further PSU staff action required. Once a HEART case record is closed, PSU staff cannot add notes or documentation. PSU staff must send a request to the PSU supervisor when a HEART case record needs to be reopened.

1850 Service Authorization System Online

Revision 19-13; Effective November 5, 2019

Service Authorization System Online (SASO) is an online database used by Program Support Unit (PSU) staff. SASO is the primary repository of service authorization information for individuals enrolled in the Texas Health and Human Services Commission (HHSC) Long Term Services and Supports (LTSS) waiver programs including:

  • Community Living Assistance and Support Services (CLASS);
  • Deaf Blind with Multiple Disabilities (DBMD);
  • Medically Dependent Children Program (MDCP); and
  • STAR+PLUS Home and Community Based Services (HCBS) program.

Services must be authorized in SASO before a managed care organization (MCO) can receive payment for services delivered to members.

PSU staff use SASO to prevent dual enrollment in another Medicaid waiver program. PSU staff can also use SASO to determine if an individual received the MDCP program prior to November 1, 2016.

1860 Texas Integrated Eligibility Redesign System

Revision 19-13; Effective November 5, 2019

Texas Integrated Eligibility Redesign System (TIERS) is an online database used by Program Support Unit (PSU) staff. TIERS maintains Medicaid eligibility, age and mailing addresses for individuals, applicants and members. PSU staff use TIERS to verify an individual’s, applicant’s or member’s Medicaid eligibility, age and mailing address, and to prevent dual enrollment in another Medicaid waiver program.

1870 Texas Medicaid & Healthcare Partnership Long Term Care Online Portal

Revision 19-13; Effective November 5, 2019

The Texas Medicaid & Healthcare Partnership (TMHP) Long Term Care Online Portal (LTCOP) is an online database used by Program Support Unit (PSU), managed care organizations (MCOs) and TMHP staff. TMHP LTCOP maintains the medical necessity and level of care (MN/LOC), individual service plan (ISP), cost limit, resource utilization group (RUG) cost limits and unmet needs for applicants and members. PSU staff use the LTCOP to:

  • review an applicant’s or member’s case history;
  • verify the MCO has submitted the MN/LOC and ISP timely;
  • verify the MN/LOC has an approved MN and a RUG under the cost limit;
  • verify the ISP has the correct date range and identifies at least one unmet need;
  • adjust ISP date ranges, if applicable;
  • approve, invalidate and terminate ISPs;
  • add case notes to the narrative history;
  • generate Form H2065-D, Notification of Managed Care Program Services, following the instructions in Appendix IV, Form H2065-D STAR+PLUS HCBS Program Reason for Denial and Comments Language; and
  • generate reports.

1880 TxMedCentral

Revision 19-13; Effective November 5, 2019

TxMedCentral is a secure online bulletin board used by Program Support Unit (PSU) and managed care organizations (MCOs). TxMedCentral maintains forms and documents uploaded by PSU staff and MCOs. PSU staff and MCOs use TxMedCentral for all communications being sent to between the two parties.

PSU staff must periodically purge documents from TxMedCentral due to the volume of forms and documents being uploaded to TxMedCentral. PSU staff must electronically back up documents from the MCO’s ISP and SPW folder daily to prevent loss of form history. Texas Health and Human Services Commission (HHSC) retention policy requires forms and documents to be maintained for five years.