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:

SectionTitleChange
1410MCO Service Coordination for Nursing FacilitiesDeletes section.
1420MCO Service Coordination for Programs Serving Members with IDDDeletes section.
1430MCO Service Coordination for HCBS - Adult Mental Health ProgramDeletes section.
1440MCO Service Coordination for the Section 811 Project Rental Assistance ProgramDeletes section.
1450MCO Service Coordination for and the Medicaid for Breast and Cervical Cancer ProgramDeletes section.
3316Transfer from Another Medicaid Waiver Program to the STAR+PLUS HCBS ProgramAdds start of care date for Form H2065-D. Updates ERS email contents. 
3317Non-STAR+PLUS Individual Transitioning to the Community with STAR+PLUS HCBS ProgramAdds termination date for Form H2065-D and updates ERS email contents. Clarifies PSU coordination is only required for IDD waiver programs. 
4112MCO Contracting OptionsUpdates section title to Reserved for Future Use. Removes policy language.
4170Significant ChangesUpdates section title to Reserved for Future Use. Removes policy language.
5131Identifying Managed Care Members in TIERSRemoves MMP and STAR+PLUS plan codes. 
5310Using the TMHP Long Term Care Online PortalAdds language that MCOs do not upload amended ISPs to the MCOHub.
6300.6Unable to LocateAdds policy on processing upgrade denials.
6300.10Other ReasonsAdds policy that supervisor approval is not required for denials if the applicant is under 21. 
6400Disenrollment Request PolicyAdds policy for failure to pay R&B and copayment. 
7210Timely or Non-timely State Fair Hearing RequestAdds policy for entering an appeal in TIERS. Clarifies the fair hearings officer determines if there is good cause for non-timely appeal requests.
7212DER Procedures for Entering State Fair Hearing RequestAdds policy for creating and documenting fair hearing requests. 
8200Nursing ServicesUpdates section title to Reserved for Future Use. Removes policy language.
8210Nursing ServicesRemoves section title and policy language.
10100Long Term Services and SupportsRemoves section title and policy language.
10111DAHS LimitationsRemoves section title and policy language.
10120Day Activity and Health Services ProvidersRemoves section title and policy language.
10130Assessment for Day Activity and Health ServicesRemoves section title and policy language.
10140Reassessment for Day Activity and Health ServicesRemoves section title and policy language.
10150Authorization for Day Activity and Health ServicesRemoves section title and policy language.
10160ReauthorizationRemoves section title and policy language.
10170Transfer Between FacilitiesRemoves section title and policy language.
10180Transfer Between Managed Care OrganizationsRemoves section title and policy language.
10181Gaining MCO in Same Service AreaRemoves section title and policy language.
10182Gaining MCO in Different Service AreaRemoves section title and policy language.
Appendix XXIXSTAR+PLUS Plan CodesUpdates section title to STAR+PLUS Plan Codes. Adds STAR+PLUS and MMP plan codes.