Revision Notice 20-3; Effective December 1, 2020

 

The following change(s) were made:

Revised Title Change
2030 Managed Care Organization Coordination Updates requirements of Senate Bill 1207, Member SK-SAI MDCP review signature form. Adds headings and forms detail.
6000 Denials and Disenrollment Updates description of section to include the disenrollment policy, updates Texas Administrative Code (TAC) references and the adverse benefit notification to 10 business days. Removes the Program Support Unit (PSU) tables and procedures. Deletes Sections 6110, 6120, 6130 and 6140.
6200 Denial/Termination of Medically Dependent Children Program Clarifies denial reasons to program level denials and updates managed care organization (MCO) and PSU coordination procedures. Removes reasons not applicable per the code.
6300 Disenrollment from Managed Care Changes the section title, removes MCO denials and adds disenrollment information and a reference to the Uniform Managed Care Manual. Deletes Sections 6320, 6330, 6340, 6350, 6360 and 6370.
Appendix III LTSS Billing Matrix and Crosswalk Adds UC modifier for the CDS Option to Medically Dependent Children Program waiver services for minor home modifications and adaptive aids to Codes T2028, T2029, T2039 and S5165.
Form 2605, Form 2605-S and Instructions Member SK-SAI MDCP Review Signature Adds a new form and instructions per requirement of Senate Bill 1207.