HHSC Updates to Communication Related to Enrollment, Denials, Suspensions and Terminations

On July 1, 2023, the Health and Human Services Commission (HHSC) will begin using CLASS letters to inform an individual or their legally authorized representative (LAR) of an action taken by HHSC in accordance with 26 TAC, Chapter 259. Below is information on how to use the letters:

  • CLASS Enrollment Approval, 26 TAC §259.69
    • Letter is uploaded to the IDD portal for the Case Management Agency (CMA) after Enrollment Individual Plan of Care (IPC) is authorized.
    • Within one business day, the CMA must send the letter to the individual or LAR.
    • (DSA) and the Financial Management Services Agency (FMSA), if selected.
  • CLASS Enrollment Denials, 26 TAC §259.153
    • Letter is mailed to individual or LAR.
    • Letter is uploaded to the IDD portal for CMA after Enrollment IPC is denied.
    • HHSC sends copy of the letter to DSA and FMSA, if selected.
  • CLASS Suspensions, 26 TAC §259.157
    • Letter is uploaded to the IDD portal for the CMA after suspension is authorized by HHSC.
    • Within two business days, the CMA must send the letter to the individual or LAR, DSA, and FMSA, if selected.
  • CLASS Terminations with Advance Notice and without Advance Notice, 26 TAC §259.161, §259.163, §259.165, §259.167
    • Letter is uploaded to the IDD portal for the CMA after Termination IPC is authorized.
    • No later than the date of termination for terminations with advance notice, and upon receipt the CMA sends letter to the individual or LAR.
    • CMA must send a copy of the letter to the DSA and FMSA, if selected.
  • CLASS Terminations Due to Death
    • Letter is uploaded to the IDD portal for CMA after Termination IPC is authorized.
    • CMA sends letter to the individual’s LAR or family member.
    • Upon receipt, the CMA must send a copy of the letter to the DSA and FMSA, if selected.

Providers will continue to follow the processes outlined in the CLASS Provider Manual to notify an individual or LAR of any CLASS Program action taken by HHSC.

If you have questions about this communication, call the CLASS Message Line at 512-438-2484 or email CLASS Policy.